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The risk factors for pelvic floor trauma following vaginal delivery


Authors: I. Michalec 1;  M. Tomanová 1 ;  M. Navratilova 1;  O. Šimetka 1,2;  M. Procházka 3,4
Authors place of work: Porodnicko-gynekologická klinika FN, Ostrava, přednosta doc. MUDr. V. Unzeitig, CSc. 1;  Katedra chirugických oborů LF Ostravské univerzity, Ostrava 2;  Porodnicko-gynekologická klinika LF UP a FN, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. 3;  Ústav porodní asistence FZV LF UP, Olomouc, přednosta doc. MUDr. M. Procházka, Ph. D. 4
Published in the journal: Ceska Gynekol 2015; 80(1): 11-15

Summary

Objective:
The evaluation of the risk and protective factors for pelvic floor trauma in relation to vaginal delivery.

Design:
Review.

Setting:
Department of Obstetrics and Gynecology, University Hospital of Ostrava.

Methodology and results:
The aim was to provide a comprehensive survey of studies focused on risk factors for pelvic floor trauma following vaginal delivery; and to constitute the relationship between the risk and protective factors and levator ani injury. To state the prognosis of the pelvic floor injury before a child delivery is difficult and almost impossible, but it has been assumed that an operative vaginal delivery (obstetrical forceps) represents a significant risk factor for avulsion. The change in obstetric practice can prevent the injury and thus to reduce an adverse effect.

Conclusions:
Pregnancy and the methods of childbirth are important factors with an impact on pelvic floor injury, potentially contributing to the development of pelvic organ prolapse, and stress and anal incontinence. The recognition of the factors, the proper training of medical staff in the management of labour, and subsequently the proper treatment of perineal tears should prevent pelvic floor injury.

Keywords:
labour, avulsion, perineal tears


Zdroje

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16. Snopka, SJ., Swash, M., Henry, MM., et. al. Risk factors in childbirth causing damage to the pelvic floor innervation. Int J Colorectal Dis, 1986, 1, p. 20–24.

17. Svabik, K., Shek, KL., Dietz, HP. How much does the levator hiatus have to stretch during childbirth? BJOG, 2009, 116, p. 1657–1662.

18. Toozs-Hobson, P., Balmforth, J., Cardozo, L., et al. The effect of mode of delivery on pelvic floor functional anatomy. Int Urogynecol J, 2008, 19, p. 407–416.

19. Viktrup, L., Lose, G. The risk of stress incontinence 5 years after first delivery. Am J Obstet Gynecol, 2001, 185, p. 82–87.

20. Willis, A., Fardi, A., et al. Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery. Langenbecks Arch Surg, 2002, 387, p. 101.

Štítky
Detská gynekológia Gynekológia a pôrodníctvo Reprodukčná medicína

Článok vyšiel v časopise

Česká gynekologie

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2015 Číslo 1
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