A total of 208 women were assessed 2 years' post-delivery to record the prevalence of subjective urinary and faecal incontinence, incontinence of flatus, dyspareunia, subjective depression and sexual satisfaction. This was correlated with mode of delivery. A sample population was selected from the Cardiff Birth Survey Database, in accordance with strict inclusion and exclusion criteria. Each woman was invited to complete and return a postal questionnaire addressing symptoms of pelvic floor dysfunction. There was a significant decrease in sexual satisfaction scores in women who underwent vaginal delivery in comparison with those who underwent elective caesarean section at 2 years follow-up. There was also a significant increase in the prevalence of urinary incontinence, incontinence of flatus, dyspareunia and subjective depression in women who underwent vaginal delivery.

Urinary tract infections are common in pregnancy. In pregnancy urinary tract infections have an associated risk of premature labour. This study looks at the incidence of urinary tract infections and the method of perineal hygiene used after urination. Wiping back to front is associated with a greater risk of developing urinary tract infection than wiping front to back.

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Case reportA 21 year old primipara was referred to our unit for advice regarding mode of delivery. The woman was 38 weeks pregnant and had an oblique lie. Her pregnancy had been uncomplicated. However, she had a large congenital haemangioma of the left buttock and thigh ( Fig. 1) extending to the lower leg and foot. There was a macular telangiectatic haemangioma that was associated with lateral venous varicosities that had developed over the past few years and had become worse in pregnancy. Both lower limbs were the same length, but the left leg showed hypertrophy of the soft tissues. The index, middle and little fingers of both her hands were unduly short. She had no significant past medical pregnancy.During her pregnancy, the woman developed varicose veins of the vulva, vagina and cervix. An ultrasound scan revealed distended lower uterine and cervical veins. The fetus was normally grown, the placenta was anterior and the liquor volume slightly reduced. We sought the opinion of a dermatologist, who diagnosed the Klippel-Trenaunay syndrome.The woman remained on the antenatal ward until 39 weeks of gestation. In view of the vulval, vaginal and cervical varicosities and a persisting oblique lie, we decided to deliver her by caesarean section. A midline vertical incision in the skin was performed and a classical caesarean section was carried out. A massive plexus of varicosities filled the uterovesical fold, extending over the lower uterine segment. The lower pelvic peritoneum was also involved. A baby girl was born who cried at birth. Her weight was 3.3 kg. Following delivery, an infusion of oxytocin was administered, which caused the uterus to contract well. The varicosities that had been so prominent before delivery shrunk down considerably. The estimated blood loss was 1500 mL and the woman received a transfusion of two units of blood. She made a good postoperative recovery. In view of the increased risk of thromboembolic disease, she was treated with enoxaparin 40 mg daily and elastic stockings for seven days. DiscussionThe Klippel -Trenaunay syndrome is a rare congenital disorder first described in 1900 1 . It consists of a triad of cutaneous port-wine capillary malformations, varicose veins and hemihypertrophy of soft tissues and bone.