Evaluation of Pelvic Floor Symptoms and Sexual Function in Primiparous Women Who Underwent Operative Vaginal Delivery Versus Cesarean Delivery for Second-Stage Arrest

Crane, Andrea K.; Geller, Elizabeth J.; Bane, Heather; Ju, Rujin; Myers, Erinn M.; Matthews, Catherine A.

doi:10.1097/spv.0b013e31827bfd7b

Cited by 25 publications

(24 citation statements)

References 19 publications

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“…Accordingly, as opposed to the popular belief, it was found that the damage to the pelvic support tissue might occur not only in the second stage, but also in the first stage of labor [33]. In another study along the same lines, CD, which was performed after a pause in the second stage of labor in primiparous women, has no protective effect in terms of the PFD development [34]. Previous studies indicate that there is not sufficient evidence to recommend widespread use of elective CD for the prevention of PFD [35].…”

Section: Effect Of Normal Delivery and CD On Pfdmentioning

confidence: 88%

Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

Bozkurt

Yumru

Şahin

2014

Taiwanese Journal of Obstetrics and Gynecology

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Pelvic floor dysfunction (PFD), although seems to be simple, is a complex process that develops secondary to multifactorial factors. The incidence of PFD is increasing with increasing life expectancy. PFD is a term that refers to a broad range of clinical scenarios, including lower urinary tract excretory and defecation disorders, such as urinary and anal incontinence, overactive bladder, and pelvic organ prolapse, as well as sexual disorders. It is a financial burden on the health care system and disrupts women's quality of life. Strategies applied to decrease PFD are focused on the course of pregnancy, mode and management of delivery, and pelvic exercise methods. Many studies in the literature define traumatic birth, usage of forceps, length of the second stage of delivery, and sphincter damage as modifiable risk factors for PFD. Maternal age, fetal position, and fetal head circumference are nonmodifiable risk factors. Although numerous studies show that vaginal delivery affects pelvic floor structures and their functions in a negative way, there is not enough scientific evidence to recommend elective cesarean delivery in order to prevent development of PFD. PFD is a heterogeneous pathological condition, and the effects of pregnancy, vaginal delivery, cesarean delivery, and possible risk factors of PFD may be different from each other. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist; therefore, the isolated effects of these variables on the pelvic floor are difficult to study. The routine use of episiotomy for many years in order to prevent PFD is not recommended anymore; episiotomy should be used in selected cases, and the mediolateral procedures should be used if needed.

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Section: Effect Of Normal Delivery and CD On Pfdmentioning

confidence: 88%

Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

Bozkurt

Yumru

Şahin

2014

Taiwanese Journal of Obstetrics and Gynecology

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“…Symptoms associated with pelvic floor trauma include pain, dyspareunia, and urinary and bowel incontinence. [94][95][96][97][98][99][100] However, a longitudinal prospective cohort study nested with a two-centre RCT of routine versus restrictive episiotomy for assisted vaginal birth reported that pelvic floor morbidities associated with assisted vaginal birth are often as prevalent, if not more prevalent, in the third trimester of pregnancy than postpartum. 101 This suggests that much of the pelvic floor morbidity reported by women in the weeks and months after an assisted vaginal birth may not be causally related to the procedure.…”

Section: Evidence Level 1++mentioning

confidence: 99%

“…Vacuum and forceps birth are associated with a higher incidence of episiotomy, pelvic floor tearing, levator ani avulsion and obstetric anal sphincter injury (OASI) than spontaneous vaginal birth. Symptoms associated with pelvic floor trauma include pain, dyspareunia, and urinary and bowel incontinence . However, a longitudinal prospective cohort study nested with a two‐centre RCT of routine versus restrictive episiotomy for assisted vaginal birth reported that pelvic floor morbidities associated with assisted vaginal birth are often as prevalent, if not more prevalent, in the third trimester of pregnancy than postpartum .…”

Section: Performing Assisted Vaginal Birthmentioning

confidence: 99%

Assisted Vaginal Birth

Murphy¹,

Strachan²,

Bahl³

et al. 2020

BJOG

101

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Ensure obstetric trainees receive appropriate training in vacuum and forceps birth, including theoretical knowledge, simulation training and clinical training under direct supervision. [New 2020] P Competency should be demonstrated before conducting unsupervised births. [New 2020] P Complex assisted vaginal births should only be performed by experienced operators or under the direct supervision of an experienced operator. D Who should supervise assisted vaginal birth? An experienced operator, competent at midpelvic births, should be present from the outset to supervise all attempts at rotational or midpelvic assisted vaginal birth. D Where should assisted vaginal birth take place? RCOG Green-top Guideline No. 26 e73 of e112 ª 2020 Royal College of Obstetricians and Gynaecologists P Discontinue vacuum-assisted birth if there have been two 'pop-offs' of the instrument. Less experienced operators should seek senior support after one 'pop-off' to ensure the woman has the best chance of a successful assisted vaginal birth.

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“…OVD has not clearly been reported as an independent risk factor for alteration of sexual function [13,15,17,18]. Recently, Barbara et al [19] reported that OVD (n = 45) might be associated with poorer female sexual functioning, and specifically poorer scores on arousal, lubrication, orgasm, and global sexual functioning compared with a cesarean section group (n = 92) and lower orgasm scores compared with a spontaneous vaginal delivery group (n = 132) [19].…”

Section: Introductionmentioning

confidence: 99%

Sexual function and postpartum depression 6 months after attempted operative vaginal delivery according to fetal head station: A prospective population-based cohort study

et al. 2017

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ObjectiveTo evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on female and male sexual function and symptoms of postpartum depression (PPD) at 6 months.DesignProspective population-based cohort study.Setting1,941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital.MethodsSymptoms of female sexual dysfunction using the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12), symptoms of PPD using the Edinburgh Postnatal Depression Scale (EPDS) score, symptoms of male sexual dysfunction using the International Index of Erectile Function (IIEF-15) and perineal pain were assessed 6 months after aOVD. We measured the association between midpelvic or low aOVD and symptoms of female and male sexual function and symptoms of PPD at 6 months using multiple regression and adjusting for demographics, and risk factors of sexual dysfunction, symptoms of PPD and perineal pain with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).ResultsThe study included 907 women (46.7%) who responded to the questionnaire; 18.4% (167/907) had midpelvic aOVD, and 81.6% (740/907) low. Most women (873/907 [96.3%]) of those with partners reported sexual activity at 6 months. No significant difference was observed for PISQ-12, EPDS, IIEF-15 scores and perineal pain between mid and low pelvic groups. Compared with low pelvic aOVD, midpelvic aOVD was not significantly associated with either female or male sexual dysfunction (p = 0.89 and p = 0.76, respectively), or maternal symptoms of PPD (p = 0.83). Perineal pain significantly increased the risk of male and female sexual dysfunction and maternal symptoms of PPD at 6 months (p = 0.02, p = 0.006, and p = 0.02, respectively).ConclusionMidpelvic compared with low pelvic aOVD was not associated with an increase in sexual dysfunction, nor with symptoms of PPD at 6 months.

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Evaluation of Pelvic Floor Symptoms and Sexual Function in Primiparous Women Who Underwent Operative Vaginal Delivery Versus Cesarean Delivery for Second-Stage Arrest

Cited by 25 publications

References 19 publications

Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

Assisted Vaginal Birth

Sexual function and postpartum depression 6 months after attempted operative vaginal delivery according to fetal head station: A prospective population-based cohort study

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