[Urinary incontinence in pregnancy and prevention of perineal complications of labor].
BACKGROUND
Female urinary incontinence often manifests itself for the first time during pregnancy in a great number of women (23-50%). In many cases it is transitory in nature, the result of the stress induced by the pregnancy on the pelvic floor. In this study the authors discuss the frequency of urinary incontinence on the basis of a questionnaire administered to a limited sample group of obstetrics patients in order to identify the potential risk factors and to plan protective and rehabilitative strategies for the pelvic floor both during pregnancy and before and after delivery.


METHODS
From November 1998 until June 1999 at the Obstetrics and Gynecology Clinic of the University of L'Aquila (Italy) 150 women were surveyed by written questionnaire both before delivery and on the second day following delivery. Those who were identified as having urinary incontinence during pregnancy were readministered the questionnaire at three months following delivery.


RESULTS
Urinary incontinence was reported during pregnancy by 48% of the women under examination, which appeared, for the most part, during the third trimester of the pregnancy (in 43% of the women). No differences related to age were discovered, while a cesarean section played a protective role. For women with preexisting IUS the new pregnancy was an aggravating factor. Of the women with IUS during pregnancy who did not demonstrate preexisting symptoms only 9.4% reported persistent urinary incontinence at three months following delivery. Among women pregnant for the first time with persistent symptoms all had received episiotomies by the third month following delivery.


CONCLUSIONS
The authors of this study wish to direct their attention to the identification of women with IUS during pregnancy so that damage from delivery can be reduced to a minimum and rehabilitation strategies for the functioning of the pelvic floor can be imitated as soon as possible.
Di Stefano
M
M
Clinica Ginecologica e Ostetrica, Università degli Studi, L'Aquila.
Caserta
D
D
Marci
R
R
Moscarini
M
M
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control