The effect of the first vaginal birth on pelvic floor anatomy and dysfunction
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023698%3A_____%2F19%3AN0000018" target="_blank" >RIV/00023698:_____/19:N0000018 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/19:43918495
Result on the web
<a href="https://doi.org/10.1007/s00192-019-04044-2" target="_blank" >https://doi.org/10.1007/s00192-019-04044-2</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1007/s00192-019-04044-2" target="_blank" >10.1007/s00192-019-04044-2</a>
Alternative languages
Result language
angličtina
Original language name
The effect of the first vaginal birth on pelvic floor anatomy and dysfunction
Original language description
Introduction and hypothesis: First vaginal delivery severely interferes with pelvic floor anatomy and function. This study determines maternal and pregnancy-related risk factors for pelvic floor dysfunction (PFD), including urinary incontinence (UI), urgency, anal incontinence (AI), pelvic organ prolapse (POP) and levator ani muscle (LAM) avulsion. Methods: This is a single-centre prospective observational cohort study on healthy women in their first singleton pregnancy. All underwent clinical and 3D transperineal ultrasound examination at 6 weeks and 12 months postpartum. Objective outcomes were POP-Q and presence or absence of LAM trauma. Functional outcomes were measured by the ICIQ-SF and PISQ 12. Multivariate regression was performed to determine birth and maternal habitus-related risk factors for UI, urgency, AI, dyspareunia, LAM avulsion and ballooning. Results: Nine hundred eighty-seven women were included. Risk factors for UI were maternal age per year of age (OR: 1.09; 95% CI: 1.04-1.13; p = 0.0001) and BMI before pregnancy (OR: 1.08; 95% CI: 1.04-1.13; p = 0.001); for POP stage II+ maternal age (OR: 1.08; 95% CI: 1.08-1.14; p = 0.005). Avulsion was more likely after forceps (OR: 3.22; 95% CI:1.54-8.22; p = 0.015) but less likely after epidural analgesia (OR: 0.58; 95% CI: 0.37-0.90; p = 0.015) and grade I perineal rupture (OR: 0.50; 95% CI: 0.29-0.85; p = 0.012). Ballooning was more likely at increased maternal age (OR: 1.08; 95% CI: 1.02-1.13; p = 0.005), epidural (OR: 1.64; 95% CI: 1.06-2.55; p = 0.027) and grade I perineal rupture (OR: 1.79; 95% CI: 1.10-2.90; p = 0.018). Conclusion: Though maternal characteristics at birth such as age or BMI increase the risk of PFD, labour and birth factors play a similarly important role. The most critical risk factor for MLA avulsion was forceps delivery, while an epidural had a protective effect.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30214 - Obstetrics and gynaecology
Result continuities
Project
—
Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
International Urogynecology Journal
ISSN
0937-3462
e-ISSN
1433-3023
Volume of the periodical
30
Issue of the periodical within the volume
10
Country of publishing house
GB - UNITED KINGDOM
Number of pages
8
Pages from-to
1689-1696
UT code for WoS article
000490733000013
EID of the result in the Scopus database
2-s2.0-85069506961