{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:42:53Z","timestamp":1787164973362,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to compare the anteroposterior length of levator ani hiatus, as well as the presence and the degree of cystocele in women at risk of pelvic floor dysfunction during the postpartum period by transperineal ultrasound performed in the standing and supine positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross\u2010sectional study including women who delivered vaginally, at risk of pelvic floor dysfunction. After 8\u201312\u2009weeks postpartum, each woman underwent pelvic floor ultrasound in both standing and supine positions during the Valsalva maneuver to measure the length of hiatal anteroposterior diameter and the cystocele. Demographic and clinical data on pregnancy and delivery were recorded. Women were interviewed to collect subjective symptoms of urinary stress incontinence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study involved 100 women at risk of pelvic floor dysfunction following a vaginal delivery. The proportion of women with an anteroposterior hiatal diameter \u226560\u2009mm was significantly higher when measured standing than when measured supine (64.0 vs 47.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.016). Similarly, the frequency of cystocele detected in the standing position was higher than in the supine position (48.0 vs 17.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). The non\u2010agreement between the examinations performed in these two positions was proved by the value of Cohen's Kappa (0.36, 95% CI: 0.22\u20130.51). Also, in the subgroup of asymptomatic women, more cases of cystocele were detected in the standing position (29 cases, 39.2%) than in the supine position (12 cases, 16.2%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study shows that transperineal pelvic floor ultrasound in the postpartum period performed in the standing position, compared with the supine position, achieved a higher detection rate of cystocele and enlarged anteroposterior hiatal diameter in women at risk of pelvic floor dysfunction. These findings should be considered when evaluating the criteria to select candidates for pelvic floor rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.16627","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T07:35:36Z","timestamp":1733384136000},"page":"681-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ultrasound Diagnosis of Levator Ani Hiatus Enlargement and Cystocele in Standing and Supine Positions in the Postpartum Period"],"prefix":"10.1002","volume":"44","author":[{"given":"Carmela","family":"Coppola","sequence":"first","affiliation":[{"name":"Department of Maternal\u2010Infant Area Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan 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Sciences and Community Health, Dipartimento di Eccellenza 2023\u20102027 University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Orsi","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Infant Area Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3853"},{"key":"e_1_2_8_3_1","first-page":"446","article-title":"Pelvic organ prolapse \u2013 a review","volume":"44","author":"Dietz HP","year":"2015","journal-title":"Aust Fam Physician"},{"key":"e_1_2_8_4_1","volume-title":"Pelvic Floor Disorders","author":"Abdulaziz 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