评估产后盆底功能障碍风险因素的前瞻性研究。
Prospective study to assess risk factors for pelvic floor dysfunction after delivery.
作者信息
Serati Maurizio, Salvatore Stefano, Khullar Vik, Uccella Stefano, Bertelli Evelina, Ghezzi Fabio, Bolis Pierfrancesco
机构信息
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
出版信息
Acta Obstet Gynecol Scand. 2008;87(3):313-8. doi: 10.1080/00016340801899008.
BACKGROUND
To identify obstetric risk factors for de novo pelvic floor disorders after vaginal delivery.
METHODS
Antenatally asymptomatic women who delivered vaginally were interviewed on urinary, anal and sexual disorders antenatally, 6 and 12 months postpartum.
RESULTS
Of 967 women, 336 were included for final analysis. Urinary symptoms occurred in 27 and 23% of women at 6 and 12 months postpartum: univariate analysis showed a significant relation to the use of epidural analgesia (p =0.04) and to a second stage of labour >1 h (p =0.02), the latter was confirmed significant by multivariate analysis. Anal incontinence occurred in 7.1 and 6.8% of women at 6 and 12 months postpartum, respectively. Dyspareunia was reported by 24% at 6 months, decreasing to 8% at 12 months (p <0.0001).
CONCLUSIONS
Our study shows that a second stage longer than 1 h is associated with the development of postpartum urinary incontinence. Except for dyspareunia, pelvic floor dysfunction rarely resolves spontaneously.
背景
确定阴道分娩后新发盆底功能障碍的产科危险因素。
方法
对产前无症状且经阴道分娩的妇女在产前、产后6个月和12个月时进行关于泌尿、肛门及性功能障碍的访谈。
结果
967名妇女中，336名纳入最终分析。产后6个月和12个月时，分别有27%和23%的妇女出现泌尿症状：单因素分析显示与使用硬膜外镇痛（p = 0.04）及第二产程>1小时（p = 0.02）有显著相关性，多因素分析证实后者具有显著意义。产后6个月和12个月时，分别有7.1%和6.8%的妇女出现肛门失禁。6个月时24%的妇女报告有性交困难，12个月时降至8%（p < 0.0001）。
结论
我们的研究表明，第二产程超过1小时与产后尿失禁的发生有关。除性交困难外，盆底功能障碍很少能自发缓解。
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