MRI findings in patients considered high risk for pelvic floor injury studied serially after vaginal childbirth.
OBJECTIVE
The purpose of this article is to characterize pelvic floor injury after vaginal childbirth with serial MRI.


METHODS
MR images (3-T) were obtained early (1 month) and late (7 months) after first childbirth in 19 women with risk factors for pelvic floor injury. All women underwent multiplanar intermediate-weighted sequences, and 11 women underwent fluid-sensitive sequences. MR images were evaluated for levator edema and tears and for pubic abnormalities.


RESULTS
Three women had unilateral high-grade tears, three had unilateral low-grade tears, and one had bilateral high- and low-grade tears of the levator ani muscles. All tears were focal at the pubis. Levator edema was present in all women on initial imaging and was resolved at follow-up. Six women had bone marrow edema, five with fracture line. None showed a pattern indicating nerve damage separate from muscle tears.


CONCLUSIONS
MRI showed focal levator ani muscle tears at the pubis with bone marrow edema and fracture in patients at risk for pelvic floor injury.
Miller
Janis M
JM
School of Nursing, University of Michigan, Ann Arbor, MI 48109-5326, USA.
Brandon
Catherine
C
Jacobson
Jon A
JA
Low
Lisa Kane
LK
Zielinski
Ruth
R
Ashton-Miller
James
J
Delancey
John O L
JO
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017773:Pelvic Floor / Q000293:injuries*; D018570:Risk Assessment; D012307:Risk Factors