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Delivery and pudendal nerve function

T Tetzschner1, M Sørensen, L Jønsson

  • 1Department of Obstetrics and Gynecology, Glostrup County Hospital, Denmark.

Acta Obstetricia Et Gynecologica Scandinavica
|April 1, 1997
PubMed
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Pudendal nerve function, measured by pudendal nerve terminal motor latency (PNTML), declines after childbirth, particularly with vacuum extraction. Increased PNTML is linked to pelvic instability and urinary incontinence in women.

Area of Science:

  • Obstetrics and Gynecology
  • Neurophysiology
  • Pelvic Floor Disorders

Background:

  • Childbirth can affect pelvic floor structures and nerve function.
  • Pudendal nerve damage is a potential cause of postpartum incontinence.
  • Pelvic instability is a common complication after delivery.

Purpose of the Study:

  • To evaluate how delivery method and pelvic instability impact pudendal nerve function.
  • To correlate pudendal nerve function with anal and urinary incontinence post-delivery.

Main Methods:

  • Assessed 146 pregnant women during pregnancy and 12 weeks postpartum.
  • Measured pudendal nerve terminal motor latency (PNTML) and calculated the change (delta PNTML).
  • Prospectively recorded continence status, delivery details, and pelvic instability.

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Main Results:

  • PNTML increased significantly post-delivery in both primiparous and multiparous women.
  • Vacuum extraction delivery was associated with a greater increase in PNTML.
  • Higher delta PNTML correlated with age, pelvic instability, and vacuum extraction; urinary incontinence was linked to increased PNTML.

Conclusions:

  • Pudendal nerve terminal motor latency increases postpartum, with some cases becoming pathologic (>2.4 msec).
  • Delivery method (vacuum extraction), pelvic instability, and maternal age are key factors affecting PNTML changes.
  • Impaired pudendal nerve function post-delivery is associated with urinary incontinence.