MR features of the levator ani muscle in the immediate postpartum following cesarean delivery.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: We wanted to show that at the time of cesarean delivery, the active process of labor itself was sufficient to create early alterations of the pelvic floor musculature as detectable via magnetic resonance imaging (MRI). METHODS: Thirty primipara patients underwent pelvic MRI between the second and third day after cesarean delivery. Ten patients had a cesarean without labor while 20 patients underwent urgent cesarean delivery after the onset of labor. RESULTS: Patients undergoing active labor during cesarean had 2.7 times more abnormalities than the patients with cesareans without labor. The abnormalities the most frequently found were a hypersignal in the puborectalis (p = .004), a hypersignal in the iliococcygeus (p = .064) and a defect in the orientation of this same muscular bundle (p = .049). CONCLUSION: This preliminary study suggests that active labor during the time of a cesarean induces early lesions of the pelvic muscular floor.