DIAGNOSTIC ROLE OF MR IMAGING IN CASES OF PELVIC FLOOR DYSFUNCTION FOLLOWING CHILD BIRTH IN A TERTIARY CARE CENTER OF CENTRAL INDIA; AN OBSERVATIONAL STUDY

Pelvic floor dysfunction (PFD) is a prevalent condition among postpartum women, including disorders such as pelvic organ prolapse, urinary and fecal incontinence. Accurate diagnosis with imaging is crucial for effective management as traditional clinical assessment often underestimates the extent of dysfunction.To evaluate the diagnostic utility of magnetic resonance imaging (MRI), particularly dynamic MR defecography, in assessing structural and functional abnormalities of the pelvic floor following childbirth. A prospective observational study was conducted over 2.5 years at a tertiary care hospital in Central India, including 33 parous women aged 40–79 years referred for MRI pelvis/defecography due to symptoms of PFD. Standardized static and dynamic MRI protocols using a 3T scanner were employed. Findings were correlated with clinical data and analyzed using descriptive statistics and agreement tests.The majority of participants were multiparous women above 60 years. Chronic cough, episiotomy, and constipation were common associated risk factors. MRI identified structural abnormalities including puborectalis thickening (51.5%), levator ani defects (33.3%), and hiatal widening (33.3%). Cystocele and rectocele were each detected in 28 patients, while uterine descent was present in 26. MRI revealed multicompartmental prolapse in several asymptomatic patients. Statistical analysis showed only moderate agreement between MRI and clinical examination (κ = 0.38–0.51), highlighting MRI's superior sensitivity. High-resolution dynamic MRI provides a comprehensive, non-invasive assessment of postpartum pelvic floor dysfunction, enabling detection of subclinical and multicompartmental prolapse often missed on clinical examination to significantly improve early detection and management in postpartum women.