Perineal and vaginal tears are markers for occult levator ani trauma

Vaginal delivery is a major etiological factor in pelvic floor dysfunction, and one of the pathophysiological mechanisms seem s to involve trauma to the levator ani muscle [1]. Diagnosis in Delivery Suite is usually impossible as levator tears are commonly occult, and difficult to assess even if exposed by vaginal tears. There are a number of clinical risk factors, the most obvio us being Forceps delivery [2]. In this study we tried to determine whether vaginal and perineal tears, in particular 3 rd and 4 th de gree tears (OASIS) are an indicator of increased risk of levator trauma as diagnosed by 4D translabial ultrasound (US) at 3 - 6 months postpartum. Such clinical markers may become useful in the identification of women at high risk of levator trauma and futur e pelvic floor dysfunction.