Pregnancy, labor, delivery, and pelvic organ prolapse1

Sze, Eddie H.M.; Sherard, Gordon B.; Dolezal, Jeanette M.

doi:10.1016/s0029-7844(02)02246-9

Cited by 80 publications

(30 citation statements)

References 19 publications

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“…Similar to other authors [14,16,18], we observed a low prevalence of prolapse after cesarean section. We found prolapse stage ≥II in only 4 (7.7%) women who had undergone cesarean sections.…”

Section: Discussionsupporting

confidence: 92%

“…Using POPQ measurements, Dannecker et al [17] indicated more evidence of anterior vaginal wall descent after vaginal delivery in comparison with a nulliparous control group. Sze et al [16] reported that 97% of the 78 women with POP 6 weeks postpartum had the more severe defect in the anterior vaginal wall. Handa et al [18] also found a trend toward poorer support of the anterior vaginal wall in the vaginal delivery cohort as compared to cesarean without labor.…”

Section: Discussionmentioning

confidence: 99%

“…There has been some data published in this field, but the prolapse prevalence varies considerably. Sze et al [16] found postpartum prolapse in 50 out of 94 primiparous women (52%) 6 weeks after delivery. Similarly, O’Boyle et al [14] found POPQ stage II in two thirds of 62 primiparous women examined 5–22 weeks postpartum.…”

Section: Discussionmentioning

confidence: 99%

“…The differences may be due to timing of the postpartum evaluation. When the examination was performed shortly after delivery [14,16] it is likely that the recovery of pelvic floor structures had not yet been completed. We choose 6 months for evaluation because recovery of connective tissue and complete pelvic floor muscles contractility is known to take up to 6 months [23].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies in this field have indicated that there is an increase in the grade of prolapse in the third trimester and postpartum compared with the first trimester of pregnancy [14]. There is also some evidence indicating an association between vaginal delivery and the development of POP postpartum [14,15,16,17,18,19]. …”

Section: Introductionmentioning

confidence: 99%

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Influence of Mode of Delivery on Pelvic Organ Support 6 Months Postpartum

Diez-Itza¹,

Arrue²,

Ibañez³

et al. 2011

Gynecol Obstet Invest

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Aims: The aims of this study were to describe pelvic organ support 6 months postpartum among women who delivered by cesarean section, spontaneous and instrumental vaginal delivery, and to evaluate the differences between the groups. Methods: This was a cross-sectional study of 382 primigravid women who gave birth at Donostia Hospital during 2007. Pelvic organ support was explored 6 months postpartum using the pelvic organ prolapse quantification (POPQ) system. Joint hypermobility, height and weight were also assessed. Results: POPQ stage ≧II was present in 7.7, 18.1 and 29.0% of women who delivered by cesarean section, spontaneous and instrumental vaginal delivery, respectively. Spontaneous vaginal delivery increased the risk by more than three times (OR 3.19; 95% CI 1.07–9.49) while instrumental vaginal delivery increased it more than fivefold (OR 5.52; 95% CI 1.79–17.30) in comparison with cesarean section. Instrument-assisted delivery did not increase the risk of prolapse in women who delivered vaginally. Conclusions: Cesarean section is associated with a lower prevalence of pelvic organ prolapse after delivery. Instrument- assisted delivery is not associated with an increased risk of postpartum prolapse among women who delivered vaginally.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Influence of Mode of Delivery on Pelvic Organ Support 6 Months Postpartum

Diez-Itza¹,

Arrue²,

Ibañez³

et al. 2011

Gynecol Obstet Invest

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An 80-Year-Old Woman With Vaginal Prolapse

Cundiff¹

2005

JAMA

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Mrs H is an 80-year-old woman with Medicare insurance who recently began feeling tissue coming out of her vagina. She called to make an appointment to see her longtime gynecologist.She feels generally well and lives with her husband of more than 50 years. She has systolic hypertension and osteoporosis. Decades ago, Mrs H had 4 vaginal deliveries of healthy, term infants. She has had regular Papanicolaou smear screening, but her most recent smear showed atypical cells of undetermined significance. It was her first abnormal smear. She denies vaginal bleeding or urinary incontinence; she does experience some urinary urgency. Her bowels are regular. She is sexually active, without dyspareunia or other problems.Her medications include enalapril, hydrochlorothiazide, and alendronate. A daughter and sister have been diagnosed with breast cancer. She has good exercise tolerance, is very active, and wants to preserve her quality of life.On physical examination, the patient is a thin woman in no distress. Her weight is 125 lb, and her height is 63 inches. The blood pressure is 170/70 mm Hg, heart rate 60/min and regular. On pelvic examination, her cervix has prolapsed 2 cm past the hymen; there is very little cystocele or rectocele. Aside from the abnormal cervical smear, her laboratory values are unremarkable.Mrs H is not eager to try a pessary. She is trying to decide whether to have surgery or to do nothing about her prolapse at this point in time.

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