Academic Editor: Michael H. Dahan
Background: To compare the rate of levator ani muscle (LAM) avulsion
between normal deliveries (ND) and forceps deliveries (FD) and to determine
whether the difficulty of forceps application in FD is related to the occurrence
of LAM avulsion. Methods: This prospective observational study included
240 primiparous patients (125 ND and 115 FD). FD were classified according to the
difficulty of forceps application. The application was considered difficult if
the fetal head was in a transverse position or if it was midforceps (head engaged
by the leading part was above +2 stations) with the fetal head in the
occipito-posterior position; otherwise, the application was considered easy.
Ultrasound evaluation was performed 6 months after delivery, and complete
avulsion was diagnosed when there was abnormal insertion of the LAM in all three
central slices. Results: There were statistically significant
differences between the ND and FD groups in the presence of LAM avulsion (15.6%
vs. 38.3%; p