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Appearance of the levator ani muscle in pregnancy as assessed by 3-D MRI.

Boreham MK, Zaretsky MV, Corton MM, Alexander JM, McIntire DD, Twickler DM

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

OBJECTIVE: The purpose of this study was to describe levator ani (LA) anatomy in postterm nulliparas using 3-dimensional (3-D) magnetic resonance (MR). STUDY DESIGN: Nulliparas (n = 84) with uncomplicated, postterm pregnancies underwent an MR (4 mm slices, 0 gap) of the uterus and pelvis. LA volume and morphometry were assessed using 3-D post-processing software. RESULTS: LA insertion into the symphysis was visible in 93%, and the iliococcygeus muscle assumed a convex shape (arch) in the 92% of the 84 women. The LA shape was characterized as "U" in 53% and "V" in 47%. Mean LA volume was 13.5 (3.7) cm3. There was a positive association between LA volume and higher fetal station (P = .02) and increasing BMI (P < .001). However, no relationship between LA volume and station was found after adjusting for BMI. CONCLUSION: BMI was correlated with LA volume in postterm nulliparas. LA insertion into the symphysis and the iliococcygeus arch were well-preserved overall and morphometry was variable.

Published 5 December 2005 in Am J Obstet Gynecol, 193(6): 2159-64.
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