出産後の骨盤底障害と出産モードの関連
Joan L Blomquist1, Alvaro Muñoz2, Megan Carroll2
1Department of Gynecology, Greater Baltimore Medical Center, Maryland.
JAMA
|December 19, 2018
まとめ
帝王切開は 経分娩と比較して 尿失禁などの 骨盤底疾患のリスクを軽減します 経分娩は経失禁や骨盤臓器の転倒のリスクを高めます
科学分野:
- 産婦人科
- 骨盤健康に関する研究
背景:
- 骨盤底疾患 (PFD) は,米国の女性の約25%に影響し,出産に関連しています.
- 産後における PFD の長期的進行は十分に理解されていません.
研究 の 目的:
- 出産後の PFD の発生率を決定する.
- 産後1~2十年後に発症する PFD に関する母性および産科的要因を特定する.
主な方法:
- 最初の分娩から最大9年間,1528人の女性を追跡調査した.
- 参加者は分娩方法によって分類された. 帝王切開,自発性陰道,または手術による陰道出産.
- ストレス性尿失禁 (SUI),過活動性膀 (OAB),経失禁 (AI),骨盤臓器転倒 (POP) を含む骨盤床障害は,毎年評価されました.
主要な成果:
- 累計15年の発生率は,平均5. 1年の追跡期間で推定された.
- spontaneous vaginal deliveryと比較して,帝王切開による出産では,SUI,OAB,POPの危険性が著しく低いことが示されました.
- 手術による陰道出産は,AIとPOPの危険性が著しく高かった. より大きな生殖器の隙間は独立してPOPのリスクを増加させた.
結論:
- 帝王切開による出産は,自発的な陰道出産と比較して,SUI,OAB,POPの発生を防ぐようです.
- 手術による陰道出産は AIとPOPのリスクを高めます
- 生殖器の穴の大きさは,投与方法に関係なく,POPの重要な危険因子です.
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