Schütze Sabine, Landenberger Miriam, Heinloth Marlen, Schütze Juliane, Andres Sophia, Janni Wolfgang, Deniz Miriam
Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU.
Fundamental Sciences, University of Applied Science, Jena, DEU.
Cureus. 2023 Feb 16;15(2):e35065. doi: 10.7759/cureus.35065. eCollection 2023 Feb.
Background and objective Delivering a baby is one of the most decisive events in a woman`s life and brings along psychological and physical challenges. Therefore, the question arises: which mode of delivery is the best for the woman's health and her future life? The aim of this study was to evaluate the influence of the delivery mode on pelvic floor function and coping with birth-related pain and fear six months postpartum. Materials and methods A total of 200 primiparous women, who delivered during 2018-2019, were included in this prospective case-control study and were asked to fill out the "Pelvic floor questionnaire for pregnant women and women after childbirth" six months after delivery. The women were separated into the following groups: spontaneous vaginal delivery (n = 113), operative vaginal delivery (n = 44), and cesarean section (n = 41). The pelvic floor function as well as coping with birth-related pain and fear six months after delivery was compared. Results A significantly higher body mass index was found in the cesarean section group. A significantly worse bladder score was shown in the group with an operative vaginal delivery (p = 0.006). The total score of the questionnaire as well as the anal, prolapse, and sexual subscores showed no difference between the delivery modes. Concerning coping with birth-related pain and fear postpartum, significant differences could be seen between the modes of delivery (pain: p < 0.001; fear: p < 0.001). Women with spontaneous vaginal delivery showed better coping with pain and fear postpartum. Conclusion It must be highlighted that women who have had a surgical delivery, including the operative vaginal delivery and cesarean section, stated a lower coping with birth-related pain and fear. This study showed that an operative vaginal delivery has a negative influence on bladder function and the use should be well-indicated. Obstetricians should always be aware of this, as they can contribute to better coping. It is essential to give women the opportunity to talk about the delivery and individual experiences both in pre- and postnatal situations.
背景与目的 分娩是女性一生中最具决定性的事件之一，会带来心理和生理上的挑战。因此，问题来了：哪种分娩方式对女性的健康和未来生活最为有利？本研究的目的是评估分娩方式对产后六个月盆底功能以及应对与分娩相关的疼痛和恐惧的影响。
材料与方法 本前瞻性病例对照研究纳入了2018年至2019年期间分娩的200名初产妇，并要求她们在分娩六个月后填写“孕妇及产后妇女盆底问卷”。这些女性被分为以下几组：自然阴道分娩（n = 113）、手术阴道分娩（n = 44）和剖宫产（n = 41）。比较了分娩后六个月的盆底功能以及应对与分娩相关的疼痛和恐惧的情况。
结果 剖宫产组的体重指数明显更高。手术阴道分娩组的膀胱评分明显更差（p = 0.006）。问卷总分以及肛门、脱垂和性功能子评分在不同分娩方式之间没有差异。关于产后应对与分娩相关的疼痛和恐惧，不同分娩方式之间存在显著差异（疼痛：p < 0.001；恐惧：p < 0.001）。自然阴道分娩的女性在产后应对疼痛和恐惧方面表现更好。
结论 必须强调的是，接受过手术分娩（包括手术阴道分娩和剖宫产）的女性表示在应对与分娩相关的疼痛和恐惧方面能力较低。本研究表明，手术阴道分娩对膀胱功能有负面影响，应严格掌握其使用指征。产科医生应始终意识到这一点，因为他们可以帮助产妇更好地应对。在产前和产后情况下，给予女性谈论分娩和个人经历的机会至关重要。
