Prolonged Second Stage of Labor and Postpartum Pelvic Floor Dysfunction

Area of Science:

• Obstetrics and Gynecology
• Pelvic Floor Disorders
• Women's Health

Background:

• Parity and delivery mode are known risk factors for pelvic floor dysfunction.
• A prolonged second stage of labor (PSSL) may contribute to these issues, but evidence is not pooled.
• The association between PSSL and pelvic floor dysfunction requires further investigation.

Purpose of the Study:

• To conduct a systematic review on the association between symptoms of pelvic floor dysfunction and a prolonged second stage of labor (PSSL).

Main Methods:

• A systematic search of multiple databases (PubMed, Cochrane, Embase, SCOPUS, Web of Science, LILACS) was performed in July and December 2024.
• Included studies focused on women with PSSL and analyzed pelvic floor dysfunction symptoms.
• The ROBINS-I scale assessed the risk of bias in observational studies.

Main Results:

• Six studies were selected from 92 analyzed articles; meta-analysis was not feasible due to heterogeneity.
• Three studies found no association between PSSL and pelvic floor dysfunction, while two suggested an association with urinary incontinence.
• One study indicated a partial association, and all studies had a moderate risk of bias.

Conclusions:

• Evidence is conflicting, with half of the studies showing no association and the other half suggesting a link between PSSL and pelvic floor dysfunction.
• Further high-quality cohort studies with PSSL as a primary outcome are necessary.
• Clarifying the relationship between prolonged labor and pelvic floor issues is crucial for clinical practice.