Short-term effects of delivery methods on postpartum pelvic floor function in primiparas: a retrospective study

Abstract

Background: The present study sought to investigate the short-term effects of different delivery methods on postpartum pelvic floor function in Chinese primiparas. Methods: Primiparous women who delivered a full-term, cephalic, singleton infant at our hospital between January 1, 2018 and August 15, 2019 were recruited into this study. All women underwent pelvic floor function screening at 6-8 weeks postpartum. Tests included postpartum Pelvic Organ Prolapse Quantification (POP-Q) score, incidence of urinary incontinence, pelvic floor muscle (PFM) strength, and Pelvic Floor Distress Inventory Questionnaire-Short Form 20 (PFDI-20) score.Results: A total of 284 postpartum women were recruited into the study. Of the participants, 147 had undergone vaginal delivery, 37 had undergone intrapartum cesarean delivery (ICD), and 100 had undergone elective cesarean delivery (ECD). Points Aa, Ba, Ap, and Bp showed a greater degree of prolapse in the vaginal delivery group than in the ECD group (P≤0.05). UI was less prevalent in ECD group relative to the vaginal delivery group (P≤0.05). Tonic PFM contraction was weaker in the vaginal delivery group than in the ECD and ICD groups (P≤0.05). Significant differences were also observed between the vaginal delivery group and the ECD group with respect to PFDI-20 scores (P≤0.05).Conclusions: Compared with vaginal delivery, ECD was strongly linked to a lower risk of pelvic organ prolapse (POP) and UI, stronger tonic PFM strength, and lower PFDI-20 scores. ECD confers relatively better protection against pelvic floor dysfunction (PFD) than does ICD.

Relationship between urinary incontinence, types of delivery and prolapse

“…So far it can be observed that cesarean delivery may cause UI due to the fact that the bladder is usually detached from the uterus to allow access to the anterior segment (13) and during vaginal delivery lacerations of the anal sphincter may occur and episiotomy increased the risk of lesions of the pelvic floor muscles increasing the risk of UTI. (14) The limitations found were that there was little research done on the specific reason that causes POP (apical, posterior) in cesarean sections. Thus, for future studies, it is suggested to find the exact cause of apical and posterior POPs in cesarean section.…”