Patel Divya A, Xu Xiao, Thomason Angela D, Ransom Scott B, Ivy Julie S, DeLancey John O L
OB/GYN Health Services Research Group, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, USA..
Am J Obstet Gynecol. 2006 Jul;195(1):23-8. doi: 10.1016/j.ajog.2006.01.042. Epub 2006 Mar 30.
Female pelvic floor dysfunction is integral to the woman's role in the reproductive process, largely because of the unique anatomic features that facilitate vaginal birth and also because of the trauma that can occur during that event. Interventions such as primary elective cesarean delivery have been discussed for the primary prevention of pelvic floor dysfunction; however, existing data about potentially causal factors limit our ability to evaluate such strategies critically. Here we consider the conceptual principles of epidemiologic function and the availability of data that are necessary to make informed recommendations about prevention opportunities for pelvic floor dysfunction at delivery. Available epidemiologic data on pelvic floor dysfunction suggest that there may be substantial opportunities for the primary prevention of pelvic organ prolapse at delivery. Although definitive recommendations await further epidemiologic studies of the potential risk and benefits of obstetric practice change, it is hoped that this discussion will provide a novel, quantitative framework for the assessment of pelvic floor dysfunction prevention opportunities.
女性盆底功能障碍与女性在生殖过程中的角色密切相关，这在很大程度上是由于有助于经阴道分娩的独特解剖特征，也由于分娩过程中可能发生的创伤。诸如选择性剖宫产等干预措施已被讨论用于盆底功能障碍的一级预防；然而，关于潜在因果因素的现有数据限制了我们严格评估此类策略的能力。在此，我们考虑流行病学功能的概念原则以及做出关于分娩时盆底功能障碍预防机会的明智建议所需的数据可用性。关于盆底功能障碍的现有流行病学数据表明，在分娩时进行盆腔器官脱垂的一级预防可能有很大机会。尽管明确的建议有待对产科实践改变的潜在风险和益处进行进一步的流行病学研究，但希望本讨论将为评估盆底功能障碍预防机会提供一个新颖的定量框架。
