The Effect of Crowning Time on Levator Ani Muscle Avulsion
Recruiting now
Conditions studied: Time of the Crowning of the Fetal Head, Levator Ani Avulsion, Labor Delivery, Postpartum
In brief
Levator ani muscle is one of the main components of perineal muscles and plays a crucial role in urinary continence and pelvic organ support. An avulsion, detachment from its insertion, of this muscle can occur during vaginal birth. It is well known that this major injury can cause many symptoms such as urinary incontinence and pelvic organ prolapses. Some risk factors of this important injury have been identified in the literature, such as the use of forceps. However, to date, no study has evaluated the impact of the crowning of the fetal head during labor on perineal muscles, specifically the levator ani muscle avulsion. Hence, the objectives of this study are to evaluate the association i) the time of the crowning of the fetal head during labor and levator ani muscle avulsion, ii) the time of the crowning of the fetal head and urogynecological symptoms, and iii) use of episiotomy and levator ani muscle avulsion. Postpartum primiparous women will undergo a 4D transperineal ultrasound to evaluate their pelvic muscles and complete questionnaires assessing urogynecological symptoms.
Key facts
- Study ID
- NCT07210788
- Run by
- Université de Sherbrooke
- People needed
- 92
- Starts
- 2024-04-23
- Expected to finish
- 2027-02-01
- Last updated by the study team
- 2025-10-07
Who can join
Age: 18 and older. Sex: female. Healthy volunteers: accepted.
You may qualify if…
- Primiparous women GxT1 At term: ≥ 37+0 weeks of gestation (included) Spontaneous vaginal delivery (SVD) Cephalic presentation History of miscarriage before 20 weeks or with a fetal weight < 350g
You may not qualify if…
- Contraindications to vaginal delivery Assisted vaginal delivery Age under 18 years Shoulder dystocia Extensive pelvic reconstructive surgery (e.g., bladder exstrophy repair) Term intrauterine fetal demise Twin or multifetal pregnancy
Where it is running
- CHUS Fleurimont — Sherbrooke, Quebec, Canada (enrolling)
Full record on ClinicalTrials.gov
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