Prospective study to assess risk factors for pelvic floor dysfunction after delivery.
BACKGROUND
To identify obstetric risk factors for de novo pelvic floor disorders after vaginal delivery.


METHODS
Antenatally asymptomatic women who delivered vaginally were interviewed on urinary, anal and sexual disorders antenatally, 6 and 12 months postpartum.


RESULTS
Of 967 women, 336 were included for final analysis. Urinary symptoms occurred in 27 and 23% of women at 6 and 12 months postpartum: univariate analysis showed a significant relation to the use of epidural analgesia (p =0.04) and to a second stage of labour >1 h (p =0.02), the latter was confirmed significant by multivariate analysis. Anal incontinence occurred in 7.1 and 6.8% of women at 6 and 12 months postpartum, respectively. Dyspareunia was reported by 24% at 6 months, decreasing to 8% at 12 months (p <0.0001).


CONCLUSIONS
Our study shows that a second stage longer than 1 h is associated with the development of postpartum urinary incontinence. Except for dyspareunia, pelvic floor dysfunction rarely resolves spontaneously.
Serati
Maurizio
M
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. mauserati@hotmail.com
Salvatore
Stefano
S
Khullar
Vik
V
Uccella
Stefano
S
Bertelli
Evelina
E
Ghezzi
Fabio
F
Bolis
Pierfrancesco
P
D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004414:Dyspareunia / Q000209:etiology*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D014550:Urinary Incontinence, Stress / Q000209:etiology*