Changes in pelvic organ mobility and ligamentous laxity during pregnancy and postpartum. Review of literature and prospects
Modifications de la statique pelvienne et de la laxité ligamentaire pendant la grossesse et le post-partum. Revue de la littérature et perspectives
Résumé
INTRODUCTION: The role of pregnancy in pelvic floor disorders occurrence remains poorly known. It might exist a link between changes in ligamentous laxity and changes in pelvic organ mobility during this period. Our objective was to conduct a non-systematic review of literature about changes in pelvic organ mobility as well as in ligamentous laxity during pregnancy and postpartum. METHODS: From the PubMed, Medline, Cochrane Library and Web of Science database we have selected works which pertains clinical assessment of pelvic organ mobility (pelvic organ prolapse quantification), ultrasound assessment of levator hiatus and urethral mobility, ligamentous laxity assessment during pregnancy and postpartum. RESULTS: Clinical assessments performed in these works show an increase of pelvic organ mobility and perineal distension during pregnancy followed by a recovery phase during postpartum. Pelvic floor imaging shows an increase of levator hiatus area and urethral mobility during pregnancy then a recovery phase in postpartum. Different authors also report an increase of ligamentous laxity (upper and lower limbs) during pregnancy followed by a decrease phase in postpartum. CONCLUSION: Pelvic organ mobility, ligamentous laxity, levator hiatus and urethral mobility change in a similarly way during pregnancy (increase of mobility or distension) and postpartum (recovery). LEVEL OF EVIDENCE: 3.
Introduction. — Le rôle de la grossesse dans l’apparition des troubles de la statique pelvienne
est discuté. Il pourrait y avoir au cours de cette période un lien entre les modifications de laxité
ligamentaire et les modifications de la statique pelvienne. Notre objectif était de réaliser une
revue non systématique de la littérature concernant les modifications de la statique pelvienne
et les modifications de laxité ligamentaire au cours de la grossesse puis du post-partum.
Méthodes. — À partir des bibliothèques PubMed, Medline, ScienceDirect, Cochrane Library et
Web of Science nous avons sélectionné les travaux traitant de l’évaluation clinique de la statique
pelvienne (pelvic organ prolapse quantification), de l’évaluation échographique du hiatus des
muscles élévateurs de l’anus et de la mobilité urétrale, de la laxité ligamentaire pendant la
grossesse et en post-partum.