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[Pregnancy, childbirth and the pelvic floor]
1Klinik und Poliklinik für Gynäkologie, Klinikums der Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale. heinz.koelbl@medizin.uni-halle.de
Zentralblatt Fur Gynakologie
|February 12, 2002
Summary
Pregnancy and vaginal birth can cause stress urinary incontinence and pelvic floor damage, particularly during the first delivery. More research is needed to understand the long-term effects on women's health.
Area of Science:
- Obstetrics and Gynecology
- Urogynecology
Context:
- Pregnancy and vaginal delivery are primary causes of genuine stress urinary incontinence (SUI) and pelvic floor dysfunction.
- Existing research relies heavily on questionnaires, with a lack of prospective studies.
- Pelvic floor damage is most significant during the first childbirth experience.
Purpose:
- To highlight the significant association between childbirth and pelvic floor disorders.
- To identify specific delivery-related factors contributing to pelvic floor damage.
- To emphasize the need for prospective and longitudinal research in this area.
Summary:
- Objective findings link forceps delivery, prolonged second stage of labor, severe perineal tears (third degree), and high birth weight to significant pudendal nerve damage.
- Episiotomy does not prevent perineal tears and should be reserved for specific obstetric indications.
- Childbirth significantly impacts lower urinary tract and pelvic floor function.
Impact:
- Informs clinical practice regarding delivery interventions and their potential for causing pelvic floor damage.
- Underscores the need for improved diagnostic methods and preventative strategies for SUI and pelvic floor dysfunction.
- Guides future research directions towards longitudinal studies to fully understand long-term consequences.