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Jose Antonio Sainz Bueno - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3d ultrasound
    Neurourology and Urodynamics, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P < 0.0005) and in the Levator Ani Muscle area (8.78 cm2/9.18 cm2/9.69 cm2/15.07 cm2/11.33 cm2/12.36 cm2; P < 0.0005) was identified. Four cases of unilateral right avulsion (two vacuum and two forceps deliveries) were identified. CONCLUSIONS We conclude that the phase of delivery that causes a major increase in the area of the Levator hiatus area and in the Levator Ani Muscle area is when the fetal head reaches the 4th plane of Hodge. Furthermore, data in our paper indicates that the exact moment in which the avulsion of the Levator Ani Muscle is produced is when the bulging of the fetal head on the maternal perineum occurs.

  • evaluation of isolated urinary stress incontinence according to the type of Levator Ani Muscle lesion using 3 4d transperineal ultrasound 36 months post partum
    International Urogynecology Journal, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Maria Jose Bonomi Barby, Pamela Valdivieso Mejias, Ana Fernandez Palacin, Paloma De La Fuente Vaquero, Jose Antonio Sainz Bueno
    Abstract:

    Introduction Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with Levator Ani Muscle (LAM) microtrauma (>20% in the Levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.

  • Evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3D ultrasound.
    Neurourology and Urodynamics, 2016
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P 

Jose Antonio Garcia Mejido - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3d ultrasound
    Neurourology and Urodynamics, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P < 0.0005) and in the Levator Ani Muscle area (8.78 cm2/9.18 cm2/9.69 cm2/15.07 cm2/11.33 cm2/12.36 cm2; P < 0.0005) was identified. Four cases of unilateral right avulsion (two vacuum and two forceps deliveries) were identified. CONCLUSIONS We conclude that the phase of delivery that causes a major increase in the area of the Levator hiatus area and in the Levator Ani Muscle area is when the fetal head reaches the 4th plane of Hodge. Furthermore, data in our paper indicates that the exact moment in which the avulsion of the Levator Ani Muscle is produced is when the bulging of the fetal head on the maternal perineum occurs.

  • evaluation of isolated urinary stress incontinence according to the type of Levator Ani Muscle lesion using 3 4d transperineal ultrasound 36 months post partum
    International Urogynecology Journal, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Maria Jose Bonomi Barby, Pamela Valdivieso Mejias, Ana Fernandez Palacin, Paloma De La Fuente Vaquero, Jose Antonio Sainz Bueno
    Abstract:

    Introduction Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with Levator Ani Muscle (LAM) microtrauma (>20% in the Levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.

  • Evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3D ultrasound.
    Neurourology and Urodynamics, 2016
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P 

A Youssef - One of the best experts on this subject based on the ideXlab platform.

  • contraction of the Levator Ani Muscle during valsalva maneuver coactivation is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor
    American Journal of Obstetrics and Gynecology, 2019
    Co-Authors: R Kamel, E Montaguti, Maria Gaia Dodaro, Sherif Negm, M Momtaz, Mahmoud Soliman, G Pilu, Kypros H. Nicolaides, A Youssef
    Abstract:

    Background The Valsalva maneuver is normally accompAnied by relaxation of the Levator Ani Muscle, which stretches around the presenting part, but in some women the maneuver is accompAnied by Levator Ani Muscle contraction, which is referred to as Levator Ani Muscle coactivation. The effect of such coactivation on labor outcome in women undergoing induction of labor has not been previously assessed. Objective The aim of the study was to assess the effect of Levator Ani Muscle coactivation on labor outcome, in particular on the duration of the second and active second stage of labor, in nulliparous women undergoing induction of labor. Study Design Transperineal ultrasound was used to measure the anteroposterior diameter of the Levator hiatus, both at rest and at maximum Valsalva maneuver, in a group of nulliparous women undergoing induction of labor in 2 tertiary-level university hospitals. The correlation between anteroposterior diameter of the Levator hiatus values and Levator Ani Muscle coactivation with the mode of delivery and various labor durations was assessed. Results In total, 138 women were included in the analysis. Larger anteroposterior diameter of the Levator hiatus at Valsalva was associated with a shorter second stage (r = –0.230, P = .021) and active second stage (r = –0.338, P = .001) of labor. Women with Levator Ani Muscle coactivation had a significantly longer active second stage duration (60 ± 56 vs 28 ± 16 minutes, P Conclusion Levator Ani coactivation is associated with a longer active second stage of labor.

Maria Jose Bonomi Barby - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3d ultrasound
    Neurourology and Urodynamics, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P < 0.0005) and in the Levator Ani Muscle area (8.78 cm2/9.18 cm2/9.69 cm2/15.07 cm2/11.33 cm2/12.36 cm2; P < 0.0005) was identified. Four cases of unilateral right avulsion (two vacuum and two forceps deliveries) were identified. CONCLUSIONS We conclude that the phase of delivery that causes a major increase in the area of the Levator hiatus area and in the Levator Ani Muscle area is when the fetal head reaches the 4th plane of Hodge. Furthermore, data in our paper indicates that the exact moment in which the avulsion of the Levator Ani Muscle is produced is when the bulging of the fetal head on the maternal perineum occurs.

  • evaluation of isolated urinary stress incontinence according to the type of Levator Ani Muscle lesion using 3 4d transperineal ultrasound 36 months post partum
    International Urogynecology Journal, 2017
    Co-Authors: Jose Antonio Garcia Mejido, Maria Jose Bonomi Barby, Pamela Valdivieso Mejias, Ana Fernandez Palacin, Paloma De La Fuente Vaquero, Jose Antonio Sainz Bueno
    Abstract:

    Introduction Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with Levator Ani Muscle (LAM) microtrauma (>20% in the Levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.

  • Evaluation of Levator Ani Muscle throughout the different stages of labor by transperineal 3D ultrasound.
    Neurourology and Urodynamics, 2016
    Co-Authors: Jose Antonio Garcia Mejido, Carmen Suarez Serrano, Ana Fernendez Palacin, Adriana Aquise Pino, Maria Jose Bonomi Barby, Jose Antonio Sainz Bueno
    Abstract:

    OBJECTIVE Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor Muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which Levator Ani Muscle avulsion takes place. MATERIALS AND METHODS Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation. A prospective observational study of 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), with fetus in cephalic presentation and without serious maternal-fetal pathology. Sonographic evaluation was carried out by 3-D transperineal ultrasound during the first and second stages of labor (with fetal head in 1st, 2nd-3rd and 4th planes of Hodge), immediately postpartum and 6 months postpartum. Ultrasound parameters studied were antero-posterior and transverse diameters, as well as Levator hiatus area and Levator Ani Muscle thickness and area. RESULTS Twenty-one patients were studied (15 spontaneous deliveries; 6 instrumental deliveries). When measured with fetal head in the 4th plane of Hodge, a significant increase both in the Levator hiatus area (15.39 cm2/15.68 cm2/20.96 cm2/42.55 cm2/22.92 cm2/18.18 cm2; P 

R Kamel - One of the best experts on this subject based on the ideXlab platform.

  • contraction of the Levator Ani Muscle during valsalva maneuver coactivation is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor
    American Journal of Obstetrics and Gynecology, 2019
    Co-Authors: R Kamel, E Montaguti, Maria Gaia Dodaro, Sherif Negm, M Momtaz, Mahmoud Soliman, G Pilu, Kypros H. Nicolaides, A Youssef
    Abstract:

    Background The Valsalva maneuver is normally accompAnied by relaxation of the Levator Ani Muscle, which stretches around the presenting part, but in some women the maneuver is accompAnied by Levator Ani Muscle contraction, which is referred to as Levator Ani Muscle coactivation. The effect of such coactivation on labor outcome in women undergoing induction of labor has not been previously assessed. Objective The aim of the study was to assess the effect of Levator Ani Muscle coactivation on labor outcome, in particular on the duration of the second and active second stage of labor, in nulliparous women undergoing induction of labor. Study Design Transperineal ultrasound was used to measure the anteroposterior diameter of the Levator hiatus, both at rest and at maximum Valsalva maneuver, in a group of nulliparous women undergoing induction of labor in 2 tertiary-level university hospitals. The correlation between anteroposterior diameter of the Levator hiatus values and Levator Ani Muscle coactivation with the mode of delivery and various labor durations was assessed. Results In total, 138 women were included in the analysis. Larger anteroposterior diameter of the Levator hiatus at Valsalva was associated with a shorter second stage (r = –0.230, P = .021) and active second stage (r = –0.338, P = .001) of labor. Women with Levator Ani Muscle coactivation had a significantly longer active second stage duration (60 ± 56 vs 28 ± 16 minutes, P Conclusion Levator Ani coactivation is associated with a longer active second stage of labor.