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Comparative Study
. 2009 Nov;201(5):514.e1-7.
doi: 10.1016/j.ajog.2009.06.048. Epub 2009 Aug 15.

Pelvic structure and function at 1 month compared to 7 months by dynamic magnetic resonance after vaginal birth

Aisha A Yousuf  1 , John O L DeLancey, Catherine J Brandon, Janis M Miller
Affiliations
Comparative Study

Pelvic structure and function at 1 month compared to 7 months by dynamic magnetic resonance after vaginal birth

Aisha A Yousuf et al. Am J Obstet Gynecol. 2009 Nov.

Abstract

Objective: We sought to determine whether changes exist in location and movement of pelvic floor structures at 1 and 7 months postpartum.

Study design: Midsagittal magnetic resonance images from 13 primiparous women with birth events associated with levator ani damage at early ( approximately 1 month) and late ( approximately 7 months) postpartum time points were analyzed. Pelvic floor structure locations at rest and displacements from rest to maximum Kegel and Valsalva were determined. Urogenital and levator hiatus diameters were measured as well.

Results: The perineal body was 7.1 mm and anal verge 7.9 mm higher at 7 months postpartum (P = .003). Both the urogenital and levator hiatus diameters were smaller at 7 months (P < .05). Displacement during Kegel and Valsalva was similar between the 2 time points.

Conclusion: Resting locations of the perineal body and anal verge are higher at 7 months postpartum, but the amount of movement during Kegel or Valsalva does not change.

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Figures

Figure 1
Figure 1
MR images at Rest, Kegel and Valsalva. Three panels figure showing mid-sagittal MR images at Rest, maximum Kegel and maximum Valsalva at early (~1 month) postpartum.
Figure 2
Figure 2
Measurement scheme. 2a) Mid-sagittal MR image at rest with the locations, diameters and angle measured. 2b) Schematic representation of SCIPP line and the axes.
Figure 3
Figure 3
Pelvic floor structures locations. Approximate locations of the Perineal Body (PB), Anal verge, Bladder Neck (BN), and Cervix at rest, maximum Kegel and maximum Valsalva at early (~1 month) and late (~7 months) postpartum shown in the upright posture (medians (mm)).
Figure 4
Figure 4
The urogenital hiatus and levator hiatus diameters. The urogenital hiatus and levator hiatus diameters at rest, maximum Kegel and maximum Valsalva at early (~1 month) and late (~7 months) postpartum shown in the upright posture, diagrammatically showing decreased length (p<0.05) at late postpartum across all (medians (mm)).
Figure 5
Figure 5
5a) The individual locations of the perineal body (PB) at early and late postpartum with color codes indicating an individual with a levator ani defect (tear). 5b) The individual locations of the anal verge at early and late postpartum with color codes indicating an individual with a levator ani defect (tear).
See this image and copyright information in PMC

References

    1. Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S. Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol. 2001;98:1004–10. - PubMed
    1. Chiaffarino F, Chatenoud L, Dindelli M, et al. Reproductive factors, family history, occupation and risk of urogenital prolapse. Eur J Obstet Gynecol Reprod Biol. 1999;82:63–7. - PubMed
    1. Carley ME, Turner RJ, Scott DE, Alexander JM. Obstetric history in women with surgically corrected adult urinary incontinence or pelvic organ prolapse. J Am Assoc Gynecol Laparosc. 1999;6:85–9. - PubMed
    1. Snooks SJ, Setchell M, Swash M, Henry MM. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet. 1984;2:546–50. - PubMed
    1. Calguneri M, Bird HA, Wright V. Changes in joint laxity occurring during pregnancy. Ann Rheum Dis. 1982;41:126–8. - PMC - PubMed

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