[Changes in pelvic organ mobility and ligamentous laxity during pregnancy and postpartum. Review of literature and prospects]

Abstract

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.

Keywords: Grossesse; Hiatus des muscles élévateurs de l’anus; IRM; Laxité ligamentaire; Levator hiatus; Ligamentous laxity; MRI; Pelvic floor disorders; Pelvic organ mobility; Perineal ultrasound; Post-partum; Postpartum; Pregnancy; Statique pelvienne; Troubles périnéaux; Échographie périnéale.