Impact of selected dimensions of pelvic floor structures on the process of delivery – a review of the literature

Abstract

Muscular and connective tissue structures of the pelvic floor play a crucial role throughout a woman‘s life, exerting significant influence on the course of childbirth. Injury to these soft tissues during delivery can substantially affect a woman‘s postpartum quality of life. In recent years, research has increasingly focused on evaluating pelvic floor structures prior to labor to determine whether functional or anatomical changes contribute to the labor process and its outcomes. Transperineal ultrasound has emerged as a promising tool for objectively assessing the preparedness of pelvic floor musculature for vaginal delivery. This paper summarizes current scientific evidence on the use of transperineal ultrasound in the assessment of selected dimensions of pelvic floor structures and their impact on labor progression. Several studies have demonstrated that significantly reduced dimensions of the genital hiatus are significantly associated with an increased risk of operative delivery and a prolonged second stage of labor. In the future, transperineal ultrasound may help identify women with an elevated risk of delivery-related complications. Such identification could support individualized strategies to mitigate these risks or guide the selection of the most appropriate mode of delivery, considering other clinical and obstetric factors. However, at present, pelvic floor assessment via transperineal ultrasound cannot be considered as a standalone marker for determining optimal delivery strategy. Childbirth remains a multifactorial process, and pelvic floor morphology represents only one of many variables influencing its course. Further research is needed to validate the clinical utility of this method and to establish its role in obstetric decision-making.