Pelvic floor dysfunction in the immediate puerperium, and 1 and 3 months after vaginal or cesarean delivery

• Published in: International journal of gynecology and obstetrics 2018-10, Vol.143 (1), p.94-100
• Main Authors: Colla, Cássia, Paiva, Luciana L., Ferla, Lia, Trento, Maria J.B., Vargas, Isadora M.P., Santos, Bianca A., Ferreira, Charles F., Ramos, José G.L.
• Format: Article
• Language: English
• Subjects: Adult; Brazil - epidemiology; Cesarean Section; Delivery, Obstetric - methods; Dysfunction; Fecal incontinence; Fecal Incontinence - epidemiology; Female; Humans; Longitudinal Studies; Pelvic floor; Pelvic Floor - pathology; Pelvic Floor Disorders - epidemiology; Pelvic organ prolapse; Pelvic Organ Prolapse - epidemiology; Pelvic Pain - epidemiology; Postpartum Period; Pregnancy; Prospective Studies; Surveys and Questionnaires; Urinary incontinence; Visual Analog Scale; Young Adult
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.12561

Objective To identify and assess postpartum pelvic floor dysfunction (PFD) between vaginal delivery, elective cesarean delivery (ECD), and intrapartum cesarean delivery (ICD). Methods The present prospective observational study included women aged at least 18 years with no history of pelvic surgery or lower urinary tract malformation, and who had not undergone pelvic floor muscle (PFM) training in the preceding 12 months, who underwent delivery at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil between August 1, 2016, and May 31, 2017. Participants were assessed at 48 hours (phase 1), 1 month (phase 2), and 3 months (phase 3) after delivery. Assessments included the International Consultation on Incontinence Questionnaire, Short Form (ICIQ‐SF); the Jorge‐Wexner anal incontinence scale; a self‐rated visual analog scale for pelvic pain; the pelvic organ prolapse quantification (POP‐Q) system; and a PFM perineometer. Results A total of 227 women were assessed in phase 1 (141 vaginal deliveries; 28 ICDs; and 58 ECDs), 79 in phase 2, and 41 in phase 3. The ICIQ‐SF, Jorge‐Wexner scale, visual analog scale, and perineometer measurements did not identify significant differences in relation to the type of delivery (P>0.05). Conclusion The type of delivery was not associated with differences in the short‐term development of postpartum PFD. Delivery type was not a significant risk factor for the development of short‐term postpartum pelvic floor dysfunction. This article includes a Portuguese translation of the , available in the Supporting Information section.