Evaluating the pelvic floor in obstetric patients

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Pelvic Floor Disorders

Background:

• Vaginal deliveries affect up to 40% of women, potentially causing pelvic floor denervation.
• Pelvic floor denervation is causally linked to urinary incontinence, fecal incontinence, and vaginal prolapse.

Purpose of the Study:

• To evaluate simple screening tests for detecting pelvic floor denervation after vaginal delivery.
• To identify women who may benefit from further neurological assessment.

Main Methods:

• Evaluated pelvic floor position, anal sphincter pressures, and anal electrosensitivity in 72 volunteers.
• Compared antenatal and postnatal (24-72 hours and 6-8 weeks) measurements.

Main Results:

• Parous women showed lower perineum and reduced sphincter pressures antenatally compared to nulliparas.
• Vaginal delivery resulted in a lower perineum and reduced sphincter pressures postnatally.
• Anal squeeze pressures and pelvic floor position during straining were most consistently altered.

Conclusions:

• Simple screening tests can identify women at risk for pelvic floor dysfunction.
• An estimated 28% of antenatal multiparas and 25-30% of all women delivering vaginally may require detailed neurological study.