title: Vaginal delivery and pelvic floor dysfunction: current evidence and implications for future research.
abstract: Vaginal delivery is the major risk factor for the development of pelvic organ prolapse and urinary and fecal incontinence, resulting from damage to the pelvic floor muscles, nerves and connective tissue. This article reviews the perineal trauma mechanism during vaginal delivery and discusses implications of current and future research projects.
authors.affiliation: Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, ON, Canada. maria.augusta@gmail.com
authors.forename: M A T
authors.initials: MA
authors.lastname: Bortolini
authors.forename: H P
authors.initials: HP
authors.lastname: Drutz
authors.forename: D
authors.initials: D
authors.lastname: Lovatsis
authors.forename: M
authors.initials: M
authors.lastname: Alarab
mesh_terms: D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods*; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology
references.citation: Am J Obstet Gynecol. 2003 Jan;188(1):108-15
references.pmid: 12548203
references.citation: Best Pract Res Clin Obstet Gynaecol. 2005 Dec;19(6):913-24
references.pmid: 16182608
references.citation: Obstet Gynecol. 2008 Jun;111(6):1426-34
references.pmid: 18515528
references.citation: BJU Int. 2007 Aug;100(2):414-8
references.pmid: 17555473
references.citation: Am J Pathol. 2006 Feb;168(2):519-28
references.pmid: 16436666
references.citation: Eur J Obstet Gynecol Reprod Biol. 1999 May;84(1):23-5
references.pmid: 10413222
references.citation: Clin Obstet Gynecol. 1993 Dec;36(4):897-909
references.pmid: 8293591
references.citation: Am J Obstet Gynecol. 2003 May;188(5):1205-7
references.pmid: 12748479
references.citation: Obstet Gynecol. 1995 Feb;85(2):225-8
references.pmid: 7824235
references.citation: Br J Obstet Gynaecol. 1997 May;104(5):579-85
references.pmid: 9166201
references.citation: Br J Urol. 1994 Apr;73(4):413-7
references.pmid: 8199830
references.citation: Acta Obstet Gynecol Scand. 1995 Jul;74(6):434-40
references.pmid: 7604686
references.citation: Br J Obstet Gynaecol. 1990 Sep;97(9):770-9
references.pmid: 2242361
references.citation: Obstet Gynecol. 1997 Apr;89(4):501-6
references.pmid: 9083302
references.citation: Am J Obstet Gynecol. 2003 Jul;189(1):102-12
references.pmid: 12861146
references.citation: Am J Obstet Gynecol. 2008 May;198(5):590.e1-6
references.pmid: 18455541
references.citation: Am J Obstet Gynecol. 2003 Sep;189(3):730-5
references.pmid: 14526303
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2006 Sep;17(5):498-501
references.pmid: 16365693
references.citation: Urology. 1998 Jul;52(1):143-51
references.pmid: 9671889
references.citation: Ultrasound Obstet Gynecol. 2008 Jun;31(6):676-80
references.pmid: 18470963
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2008 May;19(5):633-6
references.pmid: 17999021
references.citation: Am J Obstet Gynecol. 1982 Nov 15;144(6):636-49
references.pmid: 6890313
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Nov;19(11):1489-93
references.pmid: 18690404
references.citation: Clin Obstet Gynecol. 1993 Dec;36(4):926-38
references.pmid: 8293593
references.citation: Obstet Gynecol. 1996 Dec;88(6):1001-6
references.pmid: 8942842
references.citation: BJOG. 2005 Mar;112(3):334-9
references.pmid: 15713150
references.citation: Am J Obstet Gynecol. 2006 Jul;195(1):23-8
references.pmid: 16579934
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(4):208-14
references.pmid: 10895806
references.citation: Curr Opin Obstet Gynecol. 2009 Feb;21(1):97-100
references.pmid: 19125008
references.citation: Curr Opin Obstet Gynecol. 2002 Oct;14(5):509-14
references.pmid: 12401980
references.citation: Am J Physiol Regul Integr Comp Physiol. 2007 Apr;292(4):R1738-44
references.pmid: 17204590
references.citation: Ann N Y Acad Sci. 2007 Apr;1101:266-96
references.pmid: 17416924
references.citation: BJOG. 2008 Jul;115(8):979-84
references.pmid: 18503571
references.citation: Eur J Obstet Gynecol Reprod Biol. 2003 Nov 10;111(1):15-8
references.pmid: 14557005
references.citation: Curr Opin Obstet Gynecol. 1994 Aug;6(4):313-6
references.pmid: 7742491
references.citation: Obstet Gynecol. 2003 Jan;101(1):46-53
references.pmid: 12517644
references.citation: Clin Obstet Gynecol. 2007 Jun;50(2):510-7
references.pmid: 17513936
references.citation: Br J Obstet Gynaecol. 1998 Dec;105(12):1300-7
references.pmid: 9883922
references.citation: Obstet Gynecol Clin North Am. 1998 Dec;25(4):723-46
references.pmid: 9921553
references.citation: Am J Pathol. 2007 Feb;170(2):578-89
references.pmid: 17255326
references.citation: Obstet Gynecol. 1996 Sep;88(3):470-8
references.pmid: 8752261
references.citation: Obstet Gynecol. 2009 May;113(5):1089-1097
references.pmid: 19384125
references.citation: Obstet Gynecol. 1998 Oct;92(4 Pt 1):613-8
references.pmid: 9764638
references.citation: Lancet. 1984 Sep 8;2(8402):546-50
references.pmid: 6147604
references.citation: Neurourol Urodyn. 2004;23(2):119-26
references.pmid: 14983422
references.citation: Obstet Gynecol. 2003 Apr;101(4):671-6
references.pmid: 12681869
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(5):289-93
references.pmid: 12355287
references.citation: Obstet Gynecol. 2005 Oct;106(4):707-12
references.pmid: 16199625
references.citation: Curr Opin Obstet Gynecol. 2007 Oct;19(5):464-8
references.pmid: 17885463
references.citation: Nature. 2002 Jan 10;415(6868):171-5
references.pmid: 11805835
references.citation: N Engl J Med. 1993 Dec 23;329(26):1905-11
references.pmid: 8247054
references.citation: Am J Obstet Gynecol. 2000 Dec;183(6):1390-9; discussion 1399-401
references.pmid: 11120502
references.citation: Obstet Gynecol. 2005 Nov;106(5 Pt 1):953-63
references.pmid: 16260512
references.citation: Am J Obstet Gynecol. 2000 May;182(5):1021-3
references.pmid: 10819815
references.citation: Twin Res. 2004 Jun;7(3):254-60
references.pmid: 15193170
references.citation: Br J Obstet Gynaecol. 1985 Aug;92(8):824-8
references.pmid: 4027205
references.citation: Am J Obstet Gynecol. 1976 Nov 1;126(5):568-73
references.pmid: 984127
references.citation: Eur J Obstet Gynecol Reprod Biol. 2004 Jul 15;115(1):32-8
references.pmid: 15223162
references.citation: Neurourol Urodyn. 1999;18(6):613-21
references.pmid: 10529709
references.citation: Obstet Gynecol. 2004 Jan;103(1):31-40
references.pmid: 14704241
references.citation: Urology. 2003 Oct;62(4 Suppl 1):39-44
references.pmid: 14550836
references.citation: Br J Surg. 1990 Dec;77(12):1358-60
references.pmid: 2276018
references.citation: Best Pract Res Clin Obstet Gynaecol. 2001 Feb;15(1):63-79
references.pmid: 11359315
references.citation: Obstet Gynecol. 2000 Mar;95(3):464-71
references.pmid: 10711565
references.citation: Obstet Gynecol. 2007 Aug;110(2 Pt 1):354-62
references.pmid: 17666611
references.citation: Neurourol Urodyn. 2008;27(6):496-8
references.pmid: 18288704
references.citation: Acta Obstet Gynecol Scand. 1988;67(5):437-40
references.pmid: 3218463
references.citation: Am J Obstet Gynecol. 2004 Jul;191(1):95-9
references.pmid: 15295348
references.citation: Obstet Gynecol. 2006 Dec;108(6):1394-401
references.pmid: 17138772
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jan;19(1):65-71
references.pmid: 17522755
references.citation: Am J Obstet Gynecol. 1996 Feb;174(2):617-9
references.pmid: 8623794
references.citation: Obstet Gynecol. 2006 Dec;108(6):1388-93
references.pmid: 17138771
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jun;18(6):645-51
references.pmid: 17043741
references.citation: Obstet Gynecol. 2003 Aug;102(2):223-8
references.pmid: 12907092
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Dec;18(12):1453-8
references.pmid: 17393052
references.citation: Obstet Gynecol. 1998 Mar;91(3):364-8
references.pmid: 9491861
references.citation: Acta Obstet Gynecol Scand. 2004 Apr;83(4):383-9
references.pmid: 15005787
references.citation: J Reprod Med. 2005 Nov;50(11):827-31
references.pmid: 16419630
references.citation: CMAJ. 2002 Feb 5;166(3):326-30
references.pmid: 11868640
references.citation: Obstet Gynecol. 2005 Dec;106(6):1253-8
references.pmid: 16319249
references.citation: BJOG. 2003 Dec;110(12):1107-14
references.pmid: 14664882
references.citation: Am J Obstet Gynecol. 2007 Jul;197(1):65.e1-6
references.pmid: 17618761
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jul;19(7):977-86
references.pmid: 18265927