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2022 Feb 21

Am J Obstet Gynecol

Impact of Pushing Timing on Occult Injury of Levator Ani: Secondary Analysis of a Randomized Trial.


Gregory TW, Cahill AG, Woolfolk C, Lowder JL, Caughey AB, Srinivas SK, Tita ATN, Tuuli MG, Richter HE
Am J Obstet Gynecol. 2022 Feb 21.
PMID: 35202591.


Evidence of detachment of the levator ani muscle system is seen more frequently in patients with pelvic floor disorders. It has been suggested that passive descent of the fetus prior to pushing could be used to decrease operative vaginal delivery and levator ani muscle injury. The objective of this planned analysis was to determine whether immediate or delayed pushing was associated with an increased proportion of injury to the levator ani muscle system after a first delivery among nulliparous women.