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Risk factors for anatomic pelvic organ prolapse at 6 weeks postpartum: a prospective observational study.

Abstract：

INTRODUCTION AND HYPOTHESIS:The objective was to identify risk factors for postpartum anatomic pelvic organ prolapse (aPOP) by comparing women with and without aPOP at 6 weeks postpartum with regard to pelvic floor measurements antepartum and obstetrical characteristics. METHODS:We carried out a prospective observational cohort study including nulliparous pregnant women in a Norwegian university hospital. Participants underwent clinical examinations, including pelvic organ prolapse quantification system (POP-Q) and transperineal ultrasound at gestational week 21 and at 6 weeks postpartum. Background and obstetrical information was obtained from an electronic questionnaire and from the patient's electronic medical file respectively. Associations were estimated using logistic regression analyses. The dependent variable was aPOP, defined as POP-Q stage ≥2 at 6 weeks postpartum. Independent variables were mid-pregnancy measurements of selected POP-Q variables and levator hiatus area (LHarea), delivery route, and the presence of major levator ani muscle (LAM) injuries at 6 weeks postpartum. RESULTS:A larger LHarea, a more distensible LAM, a longer distance from the meatus urethra to the anus (Gh + Pb) and a more caudal position of the anterior vaginal wall (Ba) at mid-pregnancy were risk factors for aPOP at 6 weeks postpartum, whereas delivery route and the presence of major LAM injuries were not. CONCLUSION:Prelabor differences in the pelvic floor rather than obstetrical events were risk factors for aPOP at 6 weeks postpartum.

journal_name

Int Urogynecol J

journal_title

International urogynecology journal

authors

Reimers C,Siafarikas F,Stær-Jensen J,Småstuen MC,Bø K,Ellström Engh M

doi

10.1007/s00192-018-3650-2

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

477-482

issue

3

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-018-3650-2

journal_volume

30

pub_type

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