Objectives Pelvic floor disorders (PFD) and functional alterations are common among women and may affect quality of life. This study aimed to observe levator ani muscle (LAM) contraction by transperineal 3‐dimensional ultrasound and to explore the relationship between ultrasound‐derived pelvic floor muscle strength evaluation during contraction and clinical Oxford grading. Methods A total of 954 postpartum patients receiving pelvic floor rehabilitation at Xiamen Humanity Maternity Hospital from October 2022 to January 2025 were enrolled. Patients were categorized according to clinical Oxford muscle strength grade, and all underwent transperineal pelvic floor ultrasound. The ultrasound‐derived relative strain parameters of the LAM—specifically, changes in hiatal area, muscle length, and anteroposterior diameter during contraction—were measured to evaluate the agreement between ultrasound assessment and clinical Oxford grading. Results A significant correlation was found between ultrasound‐based assessments and clinical Oxford grading ( p < .001). The change in LAM anteroposterior diameter during contraction showed the highest correlation with Oxford grade ( ρ = 0.809), followed closely by changes in hiatal area and muscle length ( ρ = 0.771 and ρ = 0.781, respectively). Conclusion Transperineal 3‐dimensional ultrasonography allows non‐invasive and quantitative evaluation of pelvic floor anatomy. The strong correlations between dynamic parameters and the Oxford score demonstrate its ability to objectively assess pelvic floor muscle strength. This modality may therefore contribute to the objective characterization of pelvic floor muscle function and may inform future studies in postpartum pelvic floor rehabilitation.
Yao et al. (Sat,) studied this question.