Department of Obstetrics and Gynaecology, Royal London and St Bartholomew's Hospitals, London E1 1BB, UK.
Curr Opin Obstet Gynecol. 2009 Dec;21(6):474-9. doi: 10.1097/GCO.0b013e328332a84e.
There is strong epidemiological evidence linking vaginal childbirth and the development of postpartum incontinence and prolapse. This article examines possible mechanisms of pelvic floor damage related to delivery and their possible consequences.
Histology, imaging and physiology studies have revealed that vaginal delivery results in direct pelvic muscle trauma, disruption of fascial supports and pudendal nerve injury.
Epidemiology studies implicate parity and childbirth in the development of incontinence and prolapse; however, despite imaging and functional studies revealing damage to the pelvic floor muscles, nerves and fascial supports, it is unclear what the clinical significance of these findings is. In addition, the effect of mode of delivery is uncertain, and although cesarean section reduces the risk of pelvic floor trauma, it is not entirely protective. Further research is required into the effect of pregnancy on pelvic floor dysfunction and the effect of mode of delivery.
有强有力的流行病学证据表明阴道分娩与产后尿失禁和脱垂的发生有关。本文探讨了与分娩相关的盆底损伤的可能机制及其可能的后果。
组织学、影像学和生理学研究表明，阴道分娩会导致盆底肌肉直接损伤、筋膜支持结构破裂和阴部神经损伤。
流行病学研究表明，生育次数和分娩会导致尿失禁和脱垂的发生；然而，尽管影像学和功能研究显示盆底肌肉、神经和筋膜支持结构受损，但这些发现的临床意义尚不清楚。此外，分娩方式的影响尚不确定，虽然剖宫产降低了盆底损伤的风险，但并非完全保护。需要进一步研究妊娠对盆底功能障碍的影响以及分娩方式的影响。
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