Pregnancy, labour and delivery as risk factors for pelvic organ prolapse: a systematic review

Cattani, Laura; Decoene, Judit; Page, Ann‐Sophie; Weeg, Natalie; Deprest, Jan; Dietz, Hans Peter

doi:10.1007/s00192-021-04724-y

Cited by 49 publications

(29 citation statements)

References 24 publications

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“…Among others, the meta-analysis of Cattani et al identified forceps delivery and first vaginal birth as risk factors for anatomic and symptomatic primary POP. 5 For POP recurrence, the meta-analysis of Friedman et al showed that levator defect, preoperative prolapse stage 3 or 4, family history of prolapse, and levator hiatal area are significant risk factors for POP recurrence. 6 In this paper, we will update the review of Vergeldt et al and perform a meta-analysis not only on the risk factors for primary POP but also on POP recurrence for women in the Western developed countries.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis

Schulten¹,

Claas-Quax

Weemhoff

et al. 2022

American Journal of Obstetrics and Gynecology

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Section: Introductionmentioning

confidence: 99%

Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis

Schulten¹,

Claas-Quax

Weemhoff

et al. 2022

American Journal of Obstetrics and Gynecology

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“…Detachment of the levator ani muscle from the os pubis (avulsion) during the course of vaginal childbirth is a major factor in the pathogenesis of female pelvic organ prolapse (POP) 1 . It was first described on ultrasound imaging almost two decades ago 2 , and since then, diagnosis has been standardized with the help of tomographic ultrasound imaging (TUI) [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

All or nothing? A second look at partial levator avulsion

Dietz¹,

Shek

Low

2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?This study shows that partial avulsion of the levator ani muscle is associated with pelvic organ prolapse (POP) and prolapse symptoms, with the strongest associations noted for cystocele, on both clinical examination and ultrasound imaging. The effect of partial avulsion on POP and prolapse symptoms was explained fully by its effect on hiatal area. What are the clinical implications of this work?While full unilateral or bilateral avulsion is recognized generally as a major factor in the etiology of POP, partial trauma is by no means innocuous. Partial levator trauma seems to exert its effect through widening of the levator hiatus, strengthening the interpretation of this structure as a hernia portal.

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“…Some ultrasound-based studies have found that injury to and structural deformation of the pelvic floor are independent of parity, suggesting that parity does not affect the pelvic floor as we believe [ 44 , 45 ]. In addition, another study showed that the risk of levator avulsions, symptoms of POP, and clinical findings of POP were the same between primiparas and secundiparas, yet the occurrence of symptoms of POP increased for participants with three or more deliveries when compared to participants with one delivery [ 46 ]. Additionally, since sex education was not widespread in China teenagers, multiparas were more likely to receive sex education and Kegel training than primiparas, thus improving PFM strength [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study

Fang

Huang³

et al. 2022

BMC Pregnancy Childbirth

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Objectives To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period. Methods This retrospective study included 21,302 participants who visited Fujian Maternity and Child Health Hospital from September 2019 to February 2022. All participants were assessed by medical professionals for general information and surface electromyography. Results Univariate analysis indicated that age was inversely related to tonic and endurance contractions. In contrast, all the other variables, including education level, body mass index, neonatal weight, and number of fetuses, had a positive impact on rapid, tonic, and endurance contractions. Likewise, parity was also positively associated with rapid contractions. In addition, compared with vaginal delivery, cesarean section delivery had a protective effect on the amplitude of the three types of contractions. Stepwise regression analysis showed that both age and neonatal weight had a negative linear relationship with the amplitude of rapid, tonic and endurance contractions. In contrast, the amplitude of rapid, tonic and endurance contractions significantly increased as body mass index, parity (≤ 3), education level and gestational weight gain (endurance contractions only) increased. Participants with cesarean section delivery showed positive effects on rapid, tonic, and endurance contractions compared to participants with vaginal delivery. Conclusions We found that age, neonatal weight, vaginal delivery, episiotomy, and forceps delivery were risk factors for pelvic floor muscle strength; in contrast, body mass index, parity (≤ 3) and gestational weight gain had a positive relationship with pelvic floor muscle strength.

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Pregnancy, labour and delivery as risk factors for pelvic organ prolapse: a systematic review

Cited by 49 publications

References 24 publications

Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis

Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis

All or nothing? A second look at partial levator avulsion

Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study

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