Which women are most affected by delivery-related changes in pelvic organ mobility?

OBJECTIVE

Vaginal childbirth is a risk factor for female pelvic organ prolapse and stress incontinence. Imaging studies have suggested that vaginal delivery leads to increased anterior vaginal wall mobility. The authors intended to define the relationship between antepartum pelvic organ mobility and delivery-related changes in these parameters.

STUDY DESIGN

Prospective observational clinical study conducted on 200 nulliparous women recruited from antenatal clinic. Patients were assessed by translabial ultrasound in late pregnancy and 2-5 months postpartum.

RESULTS

Vaginal childbirth resulted in highly significant changes to all parameters used to describe pelvic organ mobility. These alterations were more marked in those women with limited pelvic organ mobility prior to childbirth, and these negative correlations were highly significant (anterior compartment r=-0.519, P<0.0001, central compartment r=-0.539, P<0.0001, posterior compartment r=-0.604, P<0.0001).

CONCLUSIONS

Women with little pelvic organ mobility before childbirth appear to be those that show most marked delivery-related changes.