Hübner Markus, Rothe Christiane, Plappert Claudia, Baeßler Kaven
Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.
Medizinische Fakultät der Universität Tübingen, Tübingen, Germany.
Geburtshilfe Frauenheilkd. 2022 Apr 5;82(4):400-409. doi: 10.1055/a-1515-2622. eCollection 2022 Apr.
The necessity of increasingly addressing aspects of pelvic floor protection, i.e., prevention of the most frequent female pelvic floor disorders, such as urinary incontinence, faecal incontinence and pelvic organ prolapse, is the result of the steadily improving understanding of the association of pregnancy and delivery with the prevalence of these disorders. About a quarter of all women experience one or more such symptoms during their life. Apart from age and weight, pregnancies and births play an important part. While initial discussion of pelvic floor protection often focused very rapidly on the mode of delivery and elective caesarean section as a possible protective intervention, it has become apparent in the last few decades how varied and wide-ranging the options are that can be used to protect against pelvic floor disorders. The mode of delivery as such is "only" one element among numerous other considerations and has diminished markedly in importance. Interprofessionality and interdisciplinarity undoubtedly represent an important development as resulting recommendations must always be incorporated in an overall context that considers mother and child at the same time. Considering the pelvic floor only certainly does not make sense. This review article will analyze in greater detail important pre-, intra- and postpartum aspects that in their entirety can provide insight into the various aspects of pelvic floor protection. The authors regard the following article as an additional basis for discussion on achieving a sustained reduction in the incidence and prevalence of female pelvic floor disorders.
越来越有必要关注盆底保护的各个方面,即预防最常见的女性盆底疾病,如尿失禁、粪失禁和盆腔器官脱垂,这是因为人们对妊娠和分娩与这些疾病患病率之间的关联的认识在不断提高。大约四分之一的女性在一生中会经历一种或多种此类症状。除了年龄和体重外,怀孕和分娩也起着重要作用。虽然最初关于盆底保护的讨论往往很快聚焦于分娩方式以及选择性剖宫产作为一种可能的保护干预措施,但在过去几十年中,人们已经清楚地认识到可用于预防盆底疾病的选择是多么多样和广泛。分娩方式本身“仅仅”是众多其他考虑因素中的一个因素,其重要性已显著下降。跨专业和跨学科无疑是一个重要的发展方向,因为最终的建议必须始终纳入一个同时考虑母亲和孩子的整体背景中。仅考虑盆底肯定是没有意义的。这篇综述文章将更详细地分析重要的产前、产中和产后方面,这些方面整体上可以深入了解盆底保护的各个方面。作者认为以下文章是进一步讨论如何持续降低女性盆底疾病发病率和患病率的额外依据。