open access

Vol 94, No 1 (2023)
Research paper
Published online: 2022-12-02
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How does the type of delivery affect pelvic floor structure? MRI parameter-based anatomical study

Ayse Rabia Senkaya1, Eren Ismailoglu2, Sabahattin Anil Ari3, Ibrahim Karaca3
DOI: 10.5603/GP.a2022.0140
·
Pubmed: 36477780
·
Ginekol Pol 2023;94(1):57-63.
Affiliations
  1. Bakircay University Faculty of Medicine, Gynecology and Obstetrics Clinic, Izmir, Turkey, Turkey
  2. Department of Radiology, Faculty of Medicine, İzmir Bakırçay University, İzmir, Turkey
  3. Bakircay University Faculty of Medicine, Gynecology and Obstetrics, Izmir, Turkey

open access

Vol 94, No 1 (2023)
ORIGINAL PAPERS Obstetrics
Published online: 2022-12-02

Abstract

Objectives: The aim of this study is to examine the effects of delivery type and birth weight on pelvic floor structure using muscle defects, uterus-vagina angles and landmarks in pelvic magnetic resonance imaging (MRI). Material and methods: This is a retrospective study. Pelvic MR images of 38 vaginal deliveries and 62 cesarean section patients who met the study criteria were analyzed. Pubococcygeal line, H line, M line were marked on MR images, uterus cervix, cervix upper vagina, upper and middle vagina, middle and lower vagina angles, urogenital hiatus width, levator hiatus width, obturator internus muscle area, levator ani defect was measured. The urinary incontinence and pelvic organ prolapse examination findings were recorded. The patients' age, body mass index (BMI), parity, delivery type, maximum birth weight questions were asked. The data of both groups were compared. Results: Uterocervical angle and levator ani muscle defect was significantly higher in the vaginal delivery group (p < 0.001). In the vaginal delivery group, a significant positive correlation was found between the parity and the levator ani muscle defect (r = 0.552), (p = 0.000). A significant negative correlation was found between the parity and the uterocervical angle (r = −0.337), (p = 0.039). A significant negative correlation was found between maximum birth weight and cervix upper vagina angle (r = −0.365) (p = 0.024). In the vaginal delivery group, a negative significant correlation was found between birth weight and obturator internus muscle area (r = −0.378), (p = 0.019). Conclusions: These results show that cesarean section exposes the pelvic floor to less trauma and suggest that cesarean section may protect the pelvic floor.

Abstract

Objectives: The aim of this study is to examine the effects of delivery type and birth weight on pelvic floor structure using muscle defects, uterus-vagina angles and landmarks in pelvic magnetic resonance imaging (MRI). Material and methods: This is a retrospective study. Pelvic MR images of 38 vaginal deliveries and 62 cesarean section patients who met the study criteria were analyzed. Pubococcygeal line, H line, M line were marked on MR images, uterus cervix, cervix upper vagina, upper and middle vagina, middle and lower vagina angles, urogenital hiatus width, levator hiatus width, obturator internus muscle area, levator ani defect was measured. The urinary incontinence and pelvic organ prolapse examination findings were recorded. The patients' age, body mass index (BMI), parity, delivery type, maximum birth weight questions were asked. The data of both groups were compared. Results: Uterocervical angle and levator ani muscle defect was significantly higher in the vaginal delivery group (p < 0.001). In the vaginal delivery group, a significant positive correlation was found between the parity and the levator ani muscle defect (r = 0.552), (p = 0.000). A significant negative correlation was found between the parity and the uterocervical angle (r = −0.337), (p = 0.039). A significant negative correlation was found between maximum birth weight and cervix upper vagina angle (r = −0.365) (p = 0.024). In the vaginal delivery group, a negative significant correlation was found between birth weight and obturator internus muscle area (r = −0.378), (p = 0.019). Conclusions: These results show that cesarean section exposes the pelvic floor to less trauma and suggest that cesarean section may protect the pelvic floor.

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Keywords

birth weight; cesarean section; parity; pelvic floor; vaginal delivery

About this article
Title

How does the type of delivery affect pelvic floor structure? MRI parameter-based anatomical study

Journal

Ginekologia Polska

Issue

Vol 94, No 1 (2023)

Article type

Research paper

Pages

57-63

Published online

2022-12-02

Page views

178

Article views/downloads

94

DOI

10.5603/GP.a2022.0140

Pubmed

36477780

Bibliographic record

Ginekol Pol 2023;94(1):57-63.

Keywords

birth weight
cesarean section
parity
pelvic floor
vaginal delivery

Authors

Ayse Rabia Senkaya
Eren Ismailoglu
Sabahattin Anil Ari
Ibrahim Karaca

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