{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:36:20Z","timestamp":1770741380619,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The present study aimed first to investigate the change in prevalence of major levator ani muscle (LAM) defects, also called avulsions, from 6\u00a0weeks to 1\u00a0year postpartum, and second to assess maternal and obstetric risk factors for having persistent major LAM defects\/avulsions at 1\u00a0year postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a secondary analysis of data from a prospective cohort study including 300 nulliparous women at 17\u201019\u00a0weeks of gestation. Major LAM defects were diagnosed at 6\u00a0weeks and 1\u00a0year postpartum using transperineal ultrasonography. We defined persistent major LAM defects as a defect diagnosed both at 6\u00a0weeks and 1\u00a0year postpartum. Maternal and obstetric data were obtained from the hospital\u2019s electronic birth records. Pelvic floor muscle function was measured vaginally by manometer at 21\u00a0weeks of gestation. The main outcome measurement was change in prevalence of major LAM defects. Maternal and obstetric risk factors for having persistent major LAM defect were also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of major LAM defects was 19.4% at 6\u00a0weeks and 10.4% at 1\u00a0year postpartum. No new major LAM defects were diagnosed at 1\u00a0year postpartum. Persisting major LAM defects were associated with longer second stage of labor (median 74.5\u00a0minutes vs median 48.0\u00a0minutes, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.012) and higher neonatal birthweight (mean difference of 232.3\u00a0g, 95% confidence interval [CI] 21.5\u2010443.1). Vacuum delivery was independently associated with persistent major LAM defects, adjusted OR 3.0 (95% CI 1.0\u20109.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a 50% reduction of sonographically diagnosed major LAM defects from 6\u00a0weeks to 1\u00a0year postpartum. This finding suggests that assessment of the major LAM 6\u00a0weeks postpartum may be too early to diagnose defects\/avulsions. Long second stage of labor, high neonatal birthweight and vacuum delivery were associated with persistent major LAM defects\/avulsions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13878","type":"journal-article","created":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T20:10:00Z","timestamp":1587586200000},"page":"1403-1410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Change in prevalence of major levator ani muscle defects from 6 weeks to 1 year postpartum, and maternal and obstetric risk factors: A longitudinal ultrasound study"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5650-4924","authenticated-orcid":false,"given":"Tuva Kristine","family":"Halle","sequence":"first","affiliation":[{"name":"Division Akershus University Hospital Faculty of Medicine University of Oslo Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital 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Hospital Faculty of Medicine University of Oslo Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Siafarikas","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital Faculty of Medicine University of Oslo Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109207.22354.65"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000250901.57095.ba"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01751.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000178779.62181.01"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02704.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10132"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13223"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000645"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14840"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11203"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2414-x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2340-y"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000194063.63206.1c"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2007.00785.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.03.028"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.11.038"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.032"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-2028-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13332"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15787"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3827-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000012"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1329-4"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22337"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930090503"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16092"},{"key":"e_1_2_9_28_1","unstructured":"Medisinsk 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