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International Urogynecology Journal

, Volume 29, Issue 5, pp 735–744 | Cite as

Dynamic 3T pelvic floor magnetic resonance imaging in women progressing from the nulligravid to the primiparous state

  • Mark E. Lockhart
  • G. Wright Bates
  • Desiree E. Morgan
  • Timothy M. Beasley
  • Holly E. RichterEmail author
Original Article

Abstract

Introduction and hypothesis

The objective was to prospectively characterize dynamic pelvic 3-Tesla magnetic resonance imaging (dp3T MRI) findings in nulligravida women and characterize changes 6 months after delivery in the same woman.

Methods

In this prospective study, nulligravida women seeking assisted reproductive technology for pregnancy were recruited. After physical examination by Pelvic Organ Prolapse Quantification (POP-Q), Brink assessment and measures including the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7, pre-pregnancy dp3T MRI at rest, with strain, and evacuation were performed. Assessments were repeated ≥6 months postpartum. Analysis included Welch and paired t tests for continuous variables, Fisher’s exact test for differences in categorical outcomes, and paired t tests for postpartum symptoms.

Results

Nineteen subjects (mean ± SD age, 31 ± 5 years) completed baseline clinical and dp3T MRI studies, 15 delivered and 10 (30.5 ± 3 years) completed pre-pregnancy and post-delivery clinical and dp3T MRI assessments. There were no significant changes in scores of validated questionnaires (all p > 0.05) or on POP-Q measures post-delivery. Two (20%) subjects without pre-pregnancy levator tears had tears on MRI post-delivery. MRI measures of pelvic organ descent were increased post-delivery. Seventeen pelvic soft-tissue parameters increased by greater than 10% post-delivery, including 5 out of 70 (7.1%), 17 out of 110 (15.5%), and 50 out of 110 (45.5%) values exceeding thresholds at rest, strain, and evacuation respectively.

Conclusions

Dynamic pelvic 3T MRI detected levator tears and increased pelvic organ descent, which can be directly attributed to pregnancy and delivery.

Keywords

Dynamic pelvic 3T magnetic resonance imaging Levator tear Nulligravida women Pelvic floor mobility Primiparous women 

Notes

Funding

Funded by NICHD 5R03HD061805–02; the NIH had no direct involvement in the design, analysis, or data collection of this study.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  • Mark E. Lockhart
    • 1
  • G. Wright Bates
    • 2
  • Desiree E. Morgan
    • 1
  • Timothy M. Beasley
    • 3
  • Holly E. Richter
    • 2
    • 4
    Email author
  1. 1.Department of RadiologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.Division Urogynecology and Pelvic Reconstructive Surgery, Department Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamUSA

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