E-Posters-Prevalence of Levator Ani Muscle Injury (LAMI) among Primiparous Women with Obstetric Anal Sphincter Injury: A Systematic Review

Prevalence of Levator Ani Muscle Injury (LAMI) among Primiparous Women with Obstetric Anal Sphincter Injury: A Systematic Review - Ahmed Elnaggar, MD MRCOG

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This systematic review aimed to determine the prevalence of Levator ani muscle injury (LAMI) among primiparous women with Obstetric Anal Sphincter Injury (OASI) and how this association could affect future anal incontinence and pelvic floor dysfunction symptoms. The review analyzed 8 studies and found that the overall rate of LAMI in patients with OASI was 34.75%. The odds ratio for a woman to have LAMI injury if she sustained OASI was 4.73. <br /><br />Three of the studies assessed anal incontinence (AI) symptoms. Two studies showed no difference in AI symptoms between LAMI+OASI compared to OASI alone, while the third study showed worsened AI symptoms with LAMI+OASI. There was no difference in stress urinary incontinence (SUI) incidence between the two groups. <br /><br />A significant decrease in Pelvic Floor Muscle Contractions (PFMC) was identified in patients with OASI and LAMI compared to OASI alone. However, the rate of Pelvic Organ Prolapse (POP) was not significantly increased with LAMI and OASI compared to OASI alone. <br /><br />The review concluded that OASI is strongly associated with Levator ani muscle injury. However, the presence of LAMI with OASI does not appear to affect the symptoms of AI, unless endo-anal ultrasound identifies a defect in the anal sphincter. There is too much heterogeneity in the analyzed studies. Additionally, the presence of LAMI with OASI does not appear to affect the symptoms of SUI.

Keywords

systematic review

levator ani muscle injury

LAMI

primiparous women

obstetric anal sphincter injury

OASI

anal incontinence

pelvic floor dysfunction

prevalence

odds ratio