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Obstetric antecedents for postpartum pelvic floor dysfunction.

Brian M Casey·Joseph I Schaffer·Steven L Bloom·Stephen F Heartwell·Donald D McIntire·Kenneth J Leveno
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Abstract

OBJECTIVE: The purpose of this study was to evaluate prospectively the association between selected obstetric antecedents and symptoms of pelvic floor dysfunction in primiparous women up to 7 months after childbirth. STUDY DESIGN: All nulliparous women who were delivered between June 1, 2000, and August 31, 2002, were eligible for a postpartum interview regarding symptoms of persistent pelvic floor dysfunction. Responses from all women who completed a survey at or before their 6-month contraceptive follow-up visit were analyzed. Obstetric antecedents to stress, urge, and anal incontinence were identified, and attributable risks for each factor were calculated. RESULTS: During the study period, 3887 of 10,643 primiparous women (37%) returned within 219 days of delivery. Symptoms of stress and urge urinary incontinence, were significantly reduced (P < .01) in women who underwent a cesarean delivery. Symptoms of urge urinary incontinence doubled in women who underwent a forceps delivery (P = .04). Symptoms of anal incontinence were increased in women who were delivered of an infant who weighed >4000 g (P = .006) and more than doubled in those women who received oxytocin and had an episiotomy performed (P = .01). CONCLUSION: The likelihood of symptoms of pelvic floor dysfunction up to 7 months after delivery was greater in women who received oxytocin, who underwent a forceps delivery, who were delivered of an infant who weighed >4000 g, or who had an episiotomy performed. Women who underwent a cesarean delivery had fewer symptoms of urge and stress urinary incontinence.

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AdultCesarean SectionDelivery, ObstetricEpisiotomyFecal IncontinenceFemaleFetal MacrosomiaHumansLikelihood FunctionsObstetrical ForcepsOdds RatioOxytocinProspective StudiesUrinary IncontinenceUrinary Incontinence, StressJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov't, P.H.S.

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BibTeXRIS

Brian M Casey, Joseph I Schaffer, Steven L Bloom, Stephen F Heartwell, Donald D McIntire, Kenneth J Leveno. 2005. Obstetric antecedents for postpartum pelvic floor dysfunction.. https://doi.org/10.1016/j.ajog.2004.11.031

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