Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Int J Gynaecol Obstet. 2018 Oct;143(1):94-100. doi: 10.1002/ijgo.12561. Epub 2018 Jun 22.
To identify and assess postpartum pelvic floor dysfunction (PFD) between vaginal delivery, elective cesarean delivery (ECD), and intrapartum cesarean delivery (ICD).
The present prospective observational study included women aged at least 18 years with no history of pelvic surgery or lower urinary tract malformation, and who had not undergone pelvic floor muscle (PFM) training in the preceding 12 months, who underwent delivery at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil between August 1, 2016, and May 31, 2017. Participants were assessed at 48 hours (phase 1), 1 month (phase 2), and 3 months (phase 3) after delivery. Assessments included the International Consultation on Incontinence Questionnaire, Short Form (ICIQ-SF); the Jorge-Wexner anal incontinence scale; a self-rated visual analog scale for pelvic pain; the pelvic organ prolapse quantification (POP-Q) system; and a PFM perineometer.
A total of 227 women were assessed in phase 1 (141 vaginal deliveries; 28 ICDs; and 58 ECDs), 79 in phase 2, and 41 in phase 3. The ICIQ-SF, Jorge-Wexner scale, visual analog scale, and perineometer measurements did not identify significant differences in relation to the type of delivery (P>0.05).
The type of delivery was not associated with differences in the short-term development of postpartum PFD.
识别和评估阴道分娩、选择性剖宫产(ECD)和产时剖宫产(ICD)后产后盆底功能障碍(PFD)。
本前瞻性观察研究纳入了年龄至少 18 岁、无盆底手术史或下尿路畸形史、且在过去 12 个月内未接受过盆底肌肉(PFM)训练的女性,她们于 2016 年 8 月 1 日至 2017 年 5 月 31 日在巴西阿雷格里港的 Hospital de Clínicas de Porto Alegre(HCPA)分娩。参与者在产后 48 小时(第 1 阶段)、1 个月(第 2 阶段)和 3 个月(第 3 阶段)进行评估。评估包括国际尿失禁咨询问卷简表(ICIQ-SF)、Jorge-Wexner 肛门失禁量表、盆腔疼痛自评视觉模拟量表、盆腔器官脱垂定量(POP-Q)系统和 PFM 会阴计。
共有 227 名女性在第 1 阶段(141 例阴道分娩;28 例 ICD;58 例 ECD)、79 名女性在第 2 阶段、41 名女性在第 3 阶段接受了评估。ICIQ-SF、Jorge-Wexner 量表、视觉模拟量表和会阴计测量结果与分娩方式之间无显著差异(P>0.05)。
分娩方式与产后 PFD 的短期发展无相关性。