Pelvic floor symptoms from first pregnancy up to 8 years after the first delivery: a longitudinal study

Halle, Tuva Kristine Toresdatter; Benth, Jūratė Šaltytė; Stær-Jensen, Jette; Reimers, C. D.; Bø, Kari; Engh, Marie Ellstrøm; Siafarikas, Franziska

doi:10.1016/j.ajog.2022.06.020

Cited by 4 publications

(4 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[9][10][11] The relationship between delivery mode and development of fecal incontinence or AI is less clear. 12 A critical time for sustaining pelvic floor morbidity may be the second stage of labor (SSL), defined as the time from complete cervical dilation to delivery. During the SSL, the fetus passes through the completely dilated cervix via expulsive forces from maternal straining and uterine contractions.…”

Section: Why This Mattersmentioning

confidence: 99%

See 1 more Smart Citation

Impact of the Duration of the Second Stage of Labor on Postpartum Pelvic Floor Symptoms

McKenzie,

Woolfolk,

Rieger

et al. 2024

UROGC

View full text Add to dashboard Cite

Importance The associated effect of duration of the second stage of labor (SSL) on pelvic floor symptoms development is not well studied. Objective This study aimed to examine the association between duration of SSL and pelvic floor symptoms at 6 months postpartum among primiparous women. Study Design A planned secondary analysis of a multicenter randomized trial evaluating the impact of immediate versus delayed pushing on vaginal delivery rates, maternal morbidity, and neonatal outcomes was conducted between 2014 and 2018. For pelvic floor arm participants, demographic, pelvic examination, and validated questionnaire data were collected postpartum. Primary outcome was change in Pelvic Floor Distress Inventory 20 (PFDI-20) score from immediate to 6 months postpartum. Secondary outcomes included changes in the Pelvic Floor Impact Questionnaire, Fecal Incontinence Severity Index, Modified Manchester Health Questionnaire scores, and Pelvic Organ Prolapse Quantification measurements at 6 months postpartum. Participants were analyzed by SSL duration ≤60 minutes or >60 minutes. Results Of the 2,414 trial participants, 767 (32%) completed pelvic floor assessments at 6 months. Pelvic Floor Distress Inventory 20 scores significantly improved at 6 months in the ≤60 minutes SSL group compared with >60 minutes SSL (−14.3 ± 48.0 and −3.2 ± 45.3, respectively; P = 0.04). Changes from immediate postpartum in total and subscale scores for other questionnaires at 6 months did not differ between groups. Prolapse stage did not differ between groups. Perineal body was significantly shorter in the >60 minutes SSL group (3.7 ± 0.7, 3.5 ± 0.8; P = 0.03). Conclusions Women with SSL >60 minutes experience less improvement in PFDI-20 scores at 6 months. Greater tissue and innervation trauma in those with SSL >60 minutes may explain persistently less improvement in PFDI-20 scores.

show abstract

Section: Why This Mattersmentioning

confidence: 99%

“…Vaginal birth, versus cesarean, is also a risk factor for SUI and urgency urinary incontinence 9–11 . The relationship between delivery mode and development of fecal incontinence or AI is less clear 12 …”

mentioning

confidence: 99%

Impact of the Duration of the Second Stage of Labor on Postpartum Pelvic Floor Symptoms

McKenzie,

Woolfolk,

Rieger

et al. 2024

UROGC

View full text Add to dashboard Cite

show abstract

“…Most of these studies have indicated that vaginal delivery increases the incidence of pelvic floor dysfunction compared to cesarean delivery (CD). [8][9][10][11] This difference may be related to the degree of levator ani muscle injury caused by the delivery. However, it is still unknown whether intrapartum CD of primiparas aggravates the damage to the pelvic floor muscles (PFM) and decreases their strength.…”

Section: Introductionmentioning

confidence: 99%

“…Several researchers have studied the effects of different delivery methods on postpartum pelvic floor function in women. Most of these studies have indicated that vaginal delivery increases the incidence of pelvic floor dysfunction compared to cesarean delivery (CD) 8–11 . This difference may be related to the degree of levator ani muscle injury caused by the delivery.…”

Section: Introductionmentioning

confidence: 99%

Association of cesarean delivery timing with pelvic floor muscle function and urine incontinence: A propensity score‐matched study

Chen

Saiding

et al. 2022

Smart Medicine

View full text Add to dashboard Cite

Pelvic floor dysfunction is a common gynecological disease that adversely affects women's quality of life and mental health. Delivery is considered a significant independent risk factor for pelvic floor dysfunction. Surface electromyography (sEMG) values for the pelvic floor muscles (PFM) have been shown to differ according to different delivery modes. This study aimed to compare sEMG results between intrapartum and antepartum cesarean delivery (CD), 42–60 days after delivery. Data of women who underwent CD at the International Peace Maternity and Child Health Hospital were collected from September 2021 to December 2021. Myotrac Infiniti System was used to measure the electromyographic activity of PFM after 42–60 days of parturition. Propensity score matching (1:1) was applied to achieve a balance in baseline data between the two groups (intrapartum and antepartum CD). A total of 200 paired cases were selected for statistical analysis. In the propensity score‐matched analysis, there were no statistically significant differences in PFM sEMG between women with antepartum or intrapartum CD (p > 0.05 for all). We observed similar results with postpartum urinary incontinence (24 [12.0] vs. 21 [10.5]; adjusted odds ratio (aOR), 1.12 [95% confidence interval (CI) 0.60–2.12]; p = 0.717) and stress urinary incontinence (12 [6.0] vs. 14 [7.0]; aOR, 0.80 [95% CI 0.35–1.80]; p = 0.596) as outcomes. After excluding participants with intrapartum CD when the cervix was dilated <6 cm, all sEMG of PFM had a comparable level of risk in both the antepartum and intrapartum CD groups. There were no significant differences in sEMG of the PFM and the incidence of urinary incontinence between patients undergoing intrapartum or antepartum CD. Excluding women who underwent intrapartum CD when the cervix was dilated to <6 cm produced little change in results. Thus, different opportunities for CD may not impact the sEMG of the PFM and the incidence of urinary incontinence.

show abstract

The association of fecal incontinence, constipation, and pelvic pain with the course of lower urinary tract symptoms in community‐dwelling men and women

Mahjoob,

Knol‐de Vries,

de Boer

et al. 2024

Neurourology and Urodynamics

View full text Add to dashboard Cite

BackgroundFecal incontinence, constipation, and pelvic pain are common pelvic floor symptoms (PFS), and frequently coexist with lower urinary tract symptoms (LUTS). However, their association with the longitudinal trajectory of LUTS have not been well described. Our objective was to investigate the association between PFS and the course of LUTS in community‐dwelling men and women.MethodsMen and women aged ≥16 years were invited to participate in a prospective observational cohort study. At baseline, and after 12 and 24 months, participants filled in the International Consultation on Incontinence Modular Questionnaire (ICIQ‐MLUTS and ICIQ‐FLUTS) for men and women respectively, the Wexner incontinence and constipation scale, and a questionnaire on pelvic pain. Generalized estimating equations were used to examine the association between change scores in defecation problems and pelvic pain, and LUTS change scores.ResultsA total of 694 men and 997 women gave informed consent, with 417 men and 566 women included in the analysis. The mean age was 63.2 ± 12.7 years for men and 58.6 ± 14.8 years for women. The study showed minor changes in LUTS scores over the 0–12 and 12–24‐month periods. Generalized estimating equations revealed positive associations between changes in constipation and fecal incontinence and LUTS changes in both sexes. For instance, a one‐point increase in Wexner constipation score was associated with 0.376 (0.165, 0.587) points higher LUTS change in men and 0.223 (0.109, 0.336) points in women during the 0–12‐month follow‐up. However, associations between changes in pain and LUTS scores varied across sexes and time periods.ConclusionsWe observed minor changes in LUTS over time and weak associations between PFS and LUTS that sometimes differed between males and females, emphasizing the need for sex‐specific considerations. These insights can provide valuable guidance for the development of targeted prevention trials, ultimately aiming to enhance overall pelvic health and patient well‐being.

show abstract

Pelvic floor symptoms from first pregnancy up to 8 years after the first delivery: a longitudinal study

Cited by 4 publications

References 41 publications

Impact of the Duration of the Second Stage of Labor on Postpartum Pelvic Floor Symptoms

Impact of the Duration of the Second Stage of Labor on Postpartum Pelvic Floor Symptoms

Association of cesarean delivery timing with pelvic floor muscle function and urine incontinence: A propensity score‐matched study

The association of fecal incontinence, constipation, and pelvic pain with the course of lower urinary tract symptoms in community‐dwelling men and women

Contact Info

Product

Resources

About