International Urogynecology Journal

, Volume 7, Issue 6, pp 321–324 | Cite as

Magnetic resonance imaging of the pelvic floor in the postpartum patient

  • S. K. Hayat
  • J. M. ThorpJr.
  • J. A. Kuller
  • B. D. Brown
  • R. C. Semelka
Original Article


Magnetic resonance imaging (MRI) was used to assess anatomical changes in the pelvic floor after childbirth. Six women underwent serial MRI examination within 30 hours and at 1 week, 2 weeks, 6 weeks and 6 months after delivery; 8 additional women were studied only within 30 hours of delivery. T-1 and T-2-weighted images of the pelvis in the transverse and sagittal planes with a 1.5-T MR imager were obtained. In the sagittal section we assessed the urethrovesical angle, urethral length, distance from the symphysis to the proximal and distal vagina, vaginal length, width and length of the sphincters, and the presence of sphincter defects. Axial sections were assessed for sphincter defects for the distance between the symphysis and midurethra, vagina and rectum. Only one parameter (distance between symphysis and distal vagina) changed significantly over time, without a clear trend in direction. Interobserver variation was reasonable (<15%) except for anal canal length, urethral length and distance between symphysis and anus. There were no significant correlations between birthweight and MRI parameters. There was a non-significant association (P=0.09) between the sole combined sphincter defect and rectal injury, but not with episiotomy or parity. We concluded that it is feasible to determine multiple measurements on MR images to evaluate structures of the pelvic floor.


Magnetic resonance imaging Pelvic floor Puerperium 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kruyt RH, Delemarre JB, Doornbos J, Vogel NJ. Normal anorectum: dynamic MR imaging anatomy.Radiology 1991; 179:159–163PubMedGoogle Scholar
  2. 2.
    Aronson MP, Lee RA, Berquist TH. Anatomy of anal sphincters and related structures in continent women studied with magnetic resonance imaging.Obstet Gynecol 1990;76:846–851PubMedGoogle Scholar
  3. 3.
    Williams AB, Brown ED, Kettritz UI, Kuller JA, Semelka RC. Anatomic changes in the pelvis after uncomplicated vaginal delivery: evaluation with serial MR imaging.Radiology 1995;195:91–94PubMedGoogle Scholar
  4. 4.
    Thorp JM Jr. Episiotomy. In: Repke JT (ed) Intrapartum obstetrics. New York: churchill Livingstone, 1996.Google Scholar
  5. 5.
    Viktrup L, Lose G, Burfoed K. The symptoms of stress incontinence caused by pregnancy or delivery in primiparas.Obstet Gynecol 1992;79:945–949PubMedGoogle Scholar
  6. 6.
    Snooks SJ et al. Effect of vaginal delivery on the pelvic floor: a 5-year follow up.Br J Surg 1979;72:1358–1360Google Scholar
  7. 7.
    Allen RE, Hosker GL, Smith ARB, Wurrel DW. Pelvic floor damage and childbirth: a neurophysiological study.Br J Obstet Gynecol 1990;97:770–779Google Scholar
  8. 8.
    Sultan AH, Kamm MAS, Hudson CN, Thomas JM, Bartram CI. Anal-sphincter disruption during vaginal delivery.N Engl J Med 1993;329:1905–1911PubMedGoogle Scholar
  9. 9.
    Sandridge DA, Thorp JM Jr. Vaginal endosonography in the assessment of the anorectum.Obstet Gynecol 1995;86:1007–1009PubMedGoogle Scholar
  10. 10.
    Law PJ, Bartrum CI. Anal endosonography: technique and normal anatomy.Gastrointest Radiol 1989;14:349–356PubMedGoogle Scholar
  11. 11.
    Pittmann JS, Berson TB, Sumners JE. Physiologic evaluation of the anorectum — a new ultrasound technique.Dis Colon Rectum 1993;36:1037–1041PubMedGoogle Scholar
  12. 12.
    Burnett SJD, Bartrum CI. Endosonographic variations in the normal internal anal sphincter.Int J Colorectal Dis 1991;6:2–4PubMedGoogle Scholar
  13. 13.
    Schafel A, Enck P, Furst G, Kahn TH, Frieling T, Lublie HJ. Anatomy of the anal sphincters: comparison of anal endosonography to magnetic resonance imaging.Dis Colon Rectum 1994;37:777–781PubMedGoogle Scholar
  14. 14.
    Hussain SM, Stoker J, Lameris JS. Anal sphincter complex: endoanal MR imaging of normal anatomy.Radiology 1995;197:671–677PubMedGoogle Scholar

Copyright information

© The International Urogynecology Journal 1996

Authors and Affiliations

  • S. K. Hayat
    • 1
  • J. M. ThorpJr.
    • 1
  • J. A. Kuller
    • 1
  • B. D. Brown
    • 1
  • R. C. Semelka
    • 1
  1. 1.Department of Obstetrics and Gynecology, Division of Maternal-Fetal MedicineUniversity of North Carolina School of MedicineChapel HillUSA

Personalised recommendations