Long-term consequences of vaginal delivery on the pelvic floor. A comparison with caesarean section in one-para women
Year: 2013
Type: dissertation
Study design: Observational Study
Abstract: \nLong-term consequences of vaginal delivery on the pelvic floor:\nA comparison with caesarean section in one-parae women\n\nUrinary incontinence (UI), symptomatic pelvic organ prolapse (sPOP), and faecal and anal\nincontinence (FI and AI) are the three major sequelae of childbirth. It has as yet not been\nfinally settled whether in the long term vaginal delivery (VD) is detrimental to pelvic floor\nfunction in comparison to caesarean section (CS). The aim of this thesis was to study the\ninfluence of childbirth on the long-term prevalence of these pelvic floor disorders (PFD) and\ntheir putative obstetric and non-obstetric risk factors by comparing two large cohorts of\nwomen after one VD compared to one CS in 2008, 20 years after childbirth. This national\ncohort study included 5236 one-parae women who gave birth in 1985-1988 and returned a\nquestionnaire on PFD in 2008. Self-reported information was linked to obstetric data from the\nSwedish Medical Birth Register.\nThe prevalence of UI; UI for more than 10 years; subtypes of UI; severe, significant and\nbothersome UI; sPOP; AI, severe AI; FI; were consistently higher after VD compared to CS.\nAfter one VD the prevalence of FI increased by about 4%, UI by 12% and sPOP by about 8%,\ncompared to one CS. After a VD women with sPOP had an almost tripled prevalence of UI\ncompared with CS. A ≥2nd degree perineal tear was associated with an almost doubled\nprevalence of FI. Episiotomy during VD was protective for FI. BMI was second to VD the\nmost important risk factor for PFD, which is important since it is modifiable.\nIn conclusion, one single VD was associated with an increased prevalence of all three of the\nmost important pelvic floor disorders - UI, sPOP, and FI - 20 years after giving birth to one\nchild.\nKey-words; Vaginal delivery, caesarean section, urinary incontinence, subtypes, bothersome,\nseverity, pelvic organ prolapse, anal incontinence, faecal incontinence, long-term,\nepidemiology, body mass index, episiotomy, perineal tear.\nISBN 978-91-628-8594-6\nhttp://hdl.handle.net/2077/31701
Author: Maria Gyhagen
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2143020841