{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:24:46Z","timestamp":1772987086786,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n This study aimed to assess the impact of delivery mode combinations after the second birth on maternal pelvic floor differences using transperineal ultrasound.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 266 women were enrolled in this study. According to the different delivery modes of two births, women were categorized as repeat vaginal birth (\n RVB<\/jats:styled-content>\n ), vaginal birth after cesarean section (\n VBAC<\/jats:styled-content>\n ), cesarean section after vaginal birth (\n CAVB<\/jats:styled-content>\n ), and repeat cesarean section (\n RCS<\/jats:styled-content>\n ) groups. Univariate analysis was performed to compare levator hiatus area (\n LHA<\/jats:styled-content>\n \u2010V), bladder neck\u2010symphyseal distance on Valsalva (\n BSD<\/jats:styled-content>\n \u2010V), bladder neck descent (\n BND<\/jats:styled-content>\n ), and the occurrence of pelvic organ prolapse (\n POP<\/jats:styled-content>\n ) among the four groups. Multiple linear regression analysis was performed to identify factors associated with\n LHA<\/jats:styled-content>\n \u2010V.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n BSD<\/jats:styled-content>\n \u2010V in the\n RVB<\/jats:styled-content>\n ,\n VBAC<\/jats:styled-content>\n and\n CAVB<\/jats:styled-content>\n groups was lower and their\n BND<\/jats:styled-content>\n was greater than the counterparts in the\n RCS<\/jats:styled-content>\n group (\n p<\/jats:italic>\n \u2009<\u20090.05). The\n VBAC<\/jats:styled-content>\n group exhibited a significantly lower\n BSD<\/jats:styled-content>\n \u2010V and greater\n BND<\/jats:styled-content>\n compared to the\n CAVB<\/jats:styled-content>\n group. The prevalence of\n POP<\/jats:styled-content>\n was the highest in the\n RVB<\/jats:styled-content>\n group and the lowest in the\n RCS<\/jats:styled-content>\n group.\n LHA<\/jats:styled-content>\n \u2010V was the only ultrasound parameter statistically different in all pairwise comparisons among the four groups. The multiple linear regression analysis results demonstrated a significant relationship between\n LHA<\/jats:styled-content>\n \u2010V and different delivery modes of two births, neonatal weight,\n BND<\/jats:styled-content>\n , uterine and perineal body position on Valsalva.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n For women with both modes, vaginal birth after cesarean section exhibited significantly lower\n BSD<\/jats:styled-content>\n \u2010V, greater\n BND<\/jats:styled-content>\n and larger\n LHA<\/jats:styled-content>\n \u2010V, with a higher prevalence of\n POP<\/jats:styled-content>\n compared to the reverse sequence. Meanwhile,\n LHA<\/jats:styled-content>\n \u2010V was identified as a sensitive ultrasound indicator for differentiating pelvic floor outcomes across delivery mode combinations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcu.70088","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:22:51Z","timestamp":1758871371000},"page":"537-545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasonic Analysis of Maternal Pelvic Floor Differences Among Delivery Mode Combinations After the Second Birth: A Single\u2010Center Study"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5163-0051","authenticated-orcid":false,"given":"Jiali","family":"Shou","sequence":"first","affiliation":[{"name":"Department of Ultrasound Medicine; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology The Third Affiliated Hospital, Guangzhou Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology The Third Affiliated Hospital, Guangzhou Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanting","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology The Third Affiliated Hospital, Guangzhou Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology The Third Affiliated Hospital, Guangzhou Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology The Third Affiliated Hospital, Guangzhou Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12026"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.08.003"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.18315"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2014.08.001"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05354-8"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2021.10.011"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3609-3"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.06.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14872"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4024"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11684-017-0561-4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14711"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1335-6"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/GMIT.GMIT_7_19"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13252"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1109-2493"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2019.07.006"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12920"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-13501-w"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181fd2356"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04550-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.11.1311"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20382"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.08.026"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12171"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15881"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04639-0"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15785"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13301"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sxmr.2019.05.007"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23524"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06366-6"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20210"},{"key":"e_1_2_9_35_1","doi-asserted-by":"crossref","first-page":"7891","DOI":"10.12659\/MSM.911343","article-title":"Correlation Between Delivery Mode and Pelvic Organ Prolapse Evaluated by Four\u2010Dimensional Pelvic Floor Ultrasonography","volume":"24","author":"Zhu Y. 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