Intra‐ and interobserver reliability of levator ani muscle biometry and avulsion using three‐dimensional endovaginal ultrasonography

ABSTRACT Objectives To test intra‐ and interobserver reliability of assessment of levator ani muscle (LAM) biometry and avulsion using antenatal and postnatal three‐dimensional (3D) endovaginal ultrasonography (EVUS), and to determine levator–urethra gap (LUG) values on EVUS. Methods Primigravid women were scanned prior to delivery, early postpartum and 3 months postpartum, with EVUS performed at rest using a standardized protocol. During post‐processing, measurements were taken in the plane of minimal hiatal dimensions by two independent investigators blinded to the clinical information and each other's results. LAM attachment to the pubic bone was assessed at the pubococcygeus and puborectalis levels using a score system: (1) intact; (2) partial avulsion (