Urogynecology in Obstetrics: Impact of Pregnancy and Delivery on Pelvic Floor Disorders, a Prospective Longitudinal Observational Pilot Study

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2021 Mar 22

PMID 33751201

Citations 6

Authors

Russalina Stroeder

Julia Radosa

Lea Clemens

Christoph Gerlinger

Gilda Schmidt

Panagiotis Sklavounos

Zoltan Takacs

Gabriele Meyberg-Solomayer

Erich-Franz Solomayer

Amr Hamza

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess changes in the pelvic floor anatomy that cause pelvic floor disorders (PFDs) in primigravidae during and after pregnancy and to evaluate their impact on women's quality of life (QoL).

Methods: POP-Q and translabial ultrasound examination was performed in the third trimester and 3 months after delivery in a cohort of primigravidae with singleton pregnancy delivering in a tertiary center. Results were analyzed regarding mode of delivery and other pre- and peripartal factors. Two individualized detailed questionnaires were distributed at 3 months and at 12 months after childbirth to determinate QoL.

Results: We recruited 45 women, of whom 17 delivered vaginally (VD), 11 received a vacuum extraction delivery (VE) and 17 a Cesarean section in labor (CS). When comparing third-trimester sonography to 3 months after delivery, bladder neck mobility increased significantly in each delivery group and hiatal area increased significantly in the VD group. A LAM avulsion was found in two women after VE. Connective tissue weakness (p = 0.0483) and fetal weight at birth (p = 0.0384) were identified as significant risk factors for the occurrence of PFDs in a multivariant regression analysis. Urinary incontinence was most common with 15% and 11% of cases at 3, respectively, 12 months after delivery. 42% of women reported discomfort during sexual intercourse, 3 months after delivery and 24% 12 months postpartum. Although 93% of women engage a midwife after delivery, only 56% participated in pelvic floor muscle training.

Conclusion: Connective tissue weakness and high fetal weight at birth are important risk factors for the occurrence of PFDs. Nevertheless, more parturients should participate in postpartal care services to prevent future PFDs.

Citing Articles

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Pelvic floor dysfunction in postpartum women: A cross-sectional study.

Gao Q, Wang M, Zhang J, Qing Y, Yang Z, Wang X PLoS One. 2024; 19(10):e0308563.

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Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China.

Zhou Y, Luo Y, Zhou Q, Xu J, Tian S, Liao B BMC Pregnancy Childbirth. 2023; 23(1):273.

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