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

Abstract

Objectives-To determine if changes exist in location and movement of pelvic floor structures at one and seven months postpartum.Study Design-Mid-sagittal MR 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 structures 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 seven months postpartum (p = 0.003). Both the urogenital and levator hiatus diameters were smaller at seven months (p < 0.05). Displacement during Kegel and Valsalva was similar between the two time-points. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Resting NIH Public Access

Longitudinal comparison study of pelvic floor function between women with and without stress urinary incontinence after vaginal delivery

“…Regarding the period for improving the morphology of the pelvic floor muscle, this study clarified that the anteroposterior diameter of the levator hiatus at rest shortened between 3 and 6 months after delivery. Our findings are similar to those of previous studies which indicated that the morphology of the pelvic floor muscle improved in the postpartum period [12,13]. The antero-posterior diameter of the levator hiatus partly reflects the morphology of the puborectalis muscle, a part of the pelvic floor muscle, because the puborectalis muscle runs around the posterior aspect of the anorectal junction from the posterior aspect of the pubis and makes the levetor hiatus.…”

“…The contractile function gradually gets weaker during pregnancy and remains significantly weaker at 6 months after vaginal delivery as compared with before delivery [9]. The supporting function also decreases during pregnancy and vaginal delivery and slowly recovers in the postpartum period [12][13][14]. According to a cross-sectional study of the etiology of stress urinary incontinence in the postpartum period, women with stress urinary incontinence have a weaker supporting function of the pelvic floor than continent women at about 3 months after delivery [15].…”

Evaluation of pelvic floor function by transabdominal ultrasound in postpartum women

“…There are three possible reasons for the differences in the absolute values of the measurements between this and previous studies. Firstly, the supporting system of the pelvic floor is assumed to be weakened in postpartum women [8,31,32] since the pelvic floor must have been distended during pregnancy. Secondly, the supine position of examinees during measurement may have affected the results in this study.…”

Evaluating maternal recovery from labor and delivery: bone and levator ani injuries

“…The first published reports from this work included: a) details on EMRLD's sampling strategies and a STROBE diagram; b) specifics of using MSK-MRI methods; c) ensuing anatomical detail of pelvic floor structures at rest, during dynamic activity, and by LA muscle subdivision and line-of-action; and d) predominant demographic or obstetric variables associated with LA tear when evaluated early postpartum. 8-12 EMRLD data collection occurred between 06/13/2005-03/14/2012, collecting data at approximately 7-weeks after a first vaginal birth (hereafter “7-wks-pp”) and again at about 8-months post-first vaginal birth (hereafter “8-mos-pp”). In this manuscript, we report the 7-wks-pp to 8-mos-pp longitudinal findings.…”