{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T22:02:40Z","timestamp":1784584960876,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"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 Ultrasound Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence of complete and partial levator ani muscle (LAM) lesions using 3\u2010dimensional endovaginal ultrasound (3D\u2010EVUS) at 3\u2010months postpartum in low\u2010risk primiparous women and evaluate associations with perineal outcomes and early urogynecological parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective interventional study of primiparous women with spontaneous vaginal delivery (March 2021\u2013May 2023) at a tertiary urogynecology center in Rome, Italy (LATA protocol, IRB: 4202). Inclusion criteria: &gt;37\u2009weeks, age 18\u201345\u2009years, body mass index (BMI) \u226520, physiologic pregnancy. Exclusion criteria: age &gt;45, BMI &lt;20, fetal macrosomia &gt;4500\u2009g, forceps delivery. Perineal outcomes were recorded at delivery. Participants underwent 3D\u2010EVUS and urogynecological assessment evaluating pelvic floor muscle function, command inversion, recruitment of auxiliary muscles, and hypertonicity at 3\u2010months postpartum. LAM lesions were classified as partial (asymmetry, irregularity, ballooning) or complete\/avulsion (detachment from pubic bone). Statistical analysis included logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 350 eligible patients, 202 completed follow\u2010up. At 3D\u2010EVUS, 52% had no LAM lesions, 45% had partial lesions, 3% had avulsions. Intact perineum was observed in 16.2% without LAM lesions, 4.4% with partial lesions, 0% with avulsion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.018). Lacerations were more frequent with partial LAM lesions (73.6%) versus no lesion (59.0%) and avulsion (33.3%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.027). Command inversion was associated with LAM lesions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004). Urogenital hiatal area under Valsalva independently predicted LAM lesions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), with area &gt;20.8\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      demonstrating 82% specificity and 45% sensitivity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>3D\u2010EVUS enables the detection of subtle lesions frequently missed by conventional approaches. Partial LAM lesions are common in primiparous women after low\u2010risk delivery, while avulsions remain rare. Command inversion and enlarged urogenital area provide valuable markers for early detection and intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70372","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:22:23Z","timestamp":1784582543000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["3D Endovaginal Ultrasound after Delivery: New Clinical and Ultrasound Insights into Levator Ani Lesions"],"prefix":"10.1002","author":[{"given":"Daniela","family":"Caramazza","sequence":"first","affiliation":[{"name":"UOC Ginecologia Chirurgica e Uroginecologia Ospedale Isola Tiberina \u2013 Gemelli Isola  Rome Italy"},{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Chirurgica e Medicina e Chirurgia Ricostruttiva Pelvica Femminile  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Moro","sequence":"additional","affiliation":[{"name":"UniCamillus\u2010Universit\u00e0 Internazionale di Medicina  Rome Italy"},{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monia","family":"Marturano","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Chirurgica e Medicina e Chirurgia Ricostruttiva Pelvica Femminile  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Vacca","sequence":"additional","affiliation":[{"name":"UOC Ginecologia Chirurgica e Uroginecologia Ospedale Isola Tiberina \u2013 Gemelli Isola  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lombisani","sequence":"additional","affiliation":[{"name":"UOC Ginecologia Chirurgica e Uroginecologia Ospedale Isola Tiberina \u2013 Gemelli Isola  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Rizzitelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Ercoli","sequence":"additional","affiliation":[{"name":"Dipartimento di Ostetricia e Ginecologia Universit\u00e0 degli studi di Roma Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia Carla","family":"Testa","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica Fondazione Policlinico Universitario A. 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