Effects of epidural analgesia during labor on pelvic floor function after vaginal delivery.
BACKGROUND
Aims of this study were to determine the rate of symptoms related to perineal trauma (anal and stress urinary incontinence) and to assess pelvic floor muscle function in women who underwent epidural analgesia.


METHODS
Comparative design comprising 70 matched pairs of primiparous mothers. Each woman was questioned about urogynecologic symptoms and examined by digital test, vaginal perineometry and uroflowmetric stop test score 3 months after vaginal delivery. Urogenital prolapse was defined in accordance with the Baden and Walker's 'Halfway System Classification'. Statistical analysis was performed using Fisher's exact test to compare the two groups and simple logistic regression models to estimate the odds ratios of every variable considered in respect of the control population.


RESULTS
No significant difference was found in the incidence of stress urinary incontinence, anal incontinence and vaginal prolapse in the two study groups. No significant differences were found between the study groups with regard to the digital test, vaginal manometry and urine stream interruption test.


CONCLUSIONS
Use of epidural analgesia is not associated with symptoms related to perineal trauma and pelvic floor muscle weakness.
Sartore
Andrea
A
Department of Obstetrics and Gynecology, I.R.C.C.S. Burlo Garofolo, University of Trieste, Italy. sartore@burlo.trieste.it
Pregazzi
Roberto
R
Bortoli
Paolo
P
Grimaldi
Eva
E
Ricci
Giuseppe
G
Guaschino
Secondo
S
D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008365:Manometry; D017773:Pelvic Floor / Q000503:physiopathology*; D010502:Perineum / Q000293:injuries / Q000502:physiology; D011247:Pregnancy; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014596:Uterine Prolapse / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014621:Vagina