Perineal body stretch during labor does not predict perineal laceration, postpartum incontinence, or postpartum sexual function: a cohort study.

Autor: Meriwether KV; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA. kvmeri01@exchange.louisville.edu.; Department of Obstetrics & Gynecology, University of Louisville, 550 S. Jackson, Louisville, KY, 40202, USA. kvmeri01@exchange.louisville.edu., Rogers RG; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA., Dunivan GC; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA., Alldredge JK; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA., Qualls C; Department of Biostatistics, Multidisciplinary Research Facility, Clinical Sciences and Translational Center, University of New Mexico, 2705 Frontier Ave., First Floor, Room 120, Albuquerque, NM, 87131, USA., Migliaccio L; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA., Leeman L; Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 4th Floor, Albuquerque, NM, 87131, USA.; Department of Family and Community Medicine, University of New Mexico, 2400 Tucker NE, Albuquerque, NM, 87131, USA.
Jazyk: angličtina
Zdroj: International urogynecology journal [Int Urogynecol J] 2016 Aug; Vol. 27 (8), pp. 1193-200. Date of Electronic Publication: 2016 Feb 13.
DOI: 10.1007/s00192-016-2959-y
Abstrakt: Introduction and Hypothesis: The perineum stretches naturally during obstetrical labor, but it is unknown whether this stretch has a negative impact on pelvic floor outcomes after a vaginal birth (VB). We aimed to evaluate whether perineal stretch was associated with postpartum pelvic floor dysfunction, and we hypothesized that greater perineal stretch would correlate with worsened outcomes.
Methods: This was a prospective cohort study of primiparous women who had a VB. Perineal body (PB) length was measured antepartum, during labor, and 6 months postpartum. We determined the maximum PB (PBmax) measurements during the second stage of labor and PB change (ΔPB) between time points. Women completed functional questionnaires and had a Pelvic Organ Prolapse Quantification (POP-Q) system exam 6 months postpartum. We analyzed the relationship of PB measurements to perineal lacerations and postpartum outcomes, including urinary, anal, and fecal incontinence, sexual activity and function, and POP-Q measurements.
Results: Four hundred and forty-eight women with VB and a mean age of 24 ± 5.0 years with rare (5 %) third- or fourth-degree lacerations were assessed. During the second stage of labor, 270/448 (60 %) had perineal measurements. Mean antepartum PB length was 3.7 ± 0.8 cm, with a maximum mean PB length (PBmax) during the second stage of 6.1 ± 1.5 cm, an increase of 65 %. The change in PB length (ΔPB) from antepartum to 6 months postpartum was a net decrease (-0.39 ± 1.02 cm). PB change and PBmax were not associated with perineal lacerations or outcomes postpartum (all p > 0.05).
Conclusions: PB stretch during labor is unrelated to perineal laceration, postpartum incontinence, sexual activity, or sexual function.
Databáze: MEDLINE
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