Wilson Don, Dornan James, Milsom Ian, Freeman Robert
Department of Obstetrics and Gynecology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Int Urogynecol J. 2014 Nov;25(11):1449-52. doi: 10.1007/s00192-014-2376-z. Epub 2014 Apr 17.
Vaginal childbirth is probably the most important factor in the aetiology of pelvic floor dysfunction (PFD) and results in the combination of some or all of the following conditions: urinary (UI) and faecal (FI) incontinence and pelvic organ prolapse (POP). Up until now, it has been difficult to counsel women antenatally regarding risk factors for subsequent PFD, as there has been little good-quality, long-term information available. We now have moderately robust epidemiological data at 12 and 20 years after delivery and objective pathophysiological data (pudendal nerve trauma and levator defects/avulsion). In this commentary, we propose a scoring system (UR-CHOICE) to predict the risk of future PFD based on several major risk factors (UI before pregnancy, ethnicity, age at birth of first child, body mass index, family history (mother and sister) of PFD and baby's weight and maternal height (if <160 cm and baby >4 kg) that have been identified for subsequent PFD risk. This scoring system will help with counselling for women regarding PFD prevention.
阴道分娩可能是盆底功能障碍（PFD）病因中最重要的因素，并导致以下部分或全部情况的组合：尿失禁（UI）、粪失禁（FI）和盆腔器官脱垂（POP）。到目前为止，很难在产前为女性提供有关后续PFD危险因素的咨询，因为几乎没有高质量的长期信息可用。我们现在有产后12年和20年的适度可靠的流行病学数据以及客观的病理生理数据（阴部神经损伤和提肌缺陷/撕脱）。在这篇评论中，我们提出了一个评分系统（UR-CHOICE），以根据已确定的后续PFD风险的几个主要危险因素（孕前尿失禁、种族、初产年龄、体重指数、PFD家族史（母亲和姐妹）以及婴儿体重和产妇身高（如果<160 cm且婴儿>4 kg））来预测未来发生PFD的风险。这个评分系统将有助于为女性提供有关预防PFD的咨询。
