Pelvic structure and function at 1 month compared to 7 months by dynamic magnetic resonance after vaginal birth
Presented at the 35th Annual Scientific Meeting of the Society of Gynecologic Surgeons, New Orleans, LA, March 30-April 1, 2009.
Received 29 December 2008; received in revised form 13 May 2009; accepted 23 June 2009. published online 17 August 2009.
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 (∼1 month) and late (∼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.
aDepartment of Obstetrics and Gynecology, University of Michigan Hospital, Ann Arbor, MI
bDepartment of Radiology, University of Michigan Hospital, Ann Arbor, MI
cSchool of Nursing, University of Michigan Hospital, Ann Arbor, MI
Reprints: Aisha A. Yousuf, MD, University of Michigan Hospital, 1500 E. Medical Center Dr., Ann Arbor, MI 48109
Cite this article as: Yousuf AA, DeLancey JOL, Brandon CJ, et al. Pelvic structure and function at 1 month compared to 7 months by dynamic magnetic resonance after vaginal birth. Am J Obstet Gynecol 2009;201:514.e1-7.
Supported by the National Institute of Child Health and Human Development Grant R21 HD 049818. Additional investigator support from the Michigan Specialized Center of Research on Sex and Gender Factors Affecting Women's Health, Grant P50 HD 44406.
ABSTRACT