Pelvic floor dysfunction one year after first childbirth in relation to perineal tear severity

Malin Huber,Ellen Malers,Katarina Tunón

doi:10.1038/s41598-021-91799-8

Malin Huber, Ellen Malers + Show 1 more

Open Access

https://doi.org/10.1038/s41598-021-91799-8

Copy DOI

Journal: Scientific Reports	Publication Date: Jun 15, 2021
Citations: 24	License type: open-access

Affiliation: Umeå University

Abstract

The aims of this study were to evaluate pelvic floor dysfunction symptoms one year after delivery and investigate whether adverse functional outcomes after childbirth were related to the degree of perineal injury. A prospective cohort of 776 primiparas were included. Self-reported pelvic floor function data were obtained using a web-based questionnaire. Women with no/first-degree injuries, second-degree injuries, third-/fourth-degree injuries (obstetric anal sphincter injury, OASI) and cesarean section were compared. A total of 511 women (66%) responded. Second-degree tears were a risk factor for stress incontinence (aOR 2.6 (95% CI 1.3–5.1)). Cesarean section was protective against stress incontinence (aOR 0.2 (95% CI 0.1–0.9)). OASI was a risk factor for urge incontinence (aOR 4.8 (95% CI 1.6–15)), prolapse (aOR 7.7 (95% CI 2.1–29)) and pelvic pain (OR 3.3 (95% CI 1.1–10)). Dyspareunia was reported by 38% of women, 63% of women in the OASI group (aOR 3.1 (95% CI 1.1–9.0)). Women with OASI reported that the injury affected daily life (OR 18 (95% CI 5.1–59)). Pelvic floor dysfunction is common after childbirth, even in women with moderate injury. Women with OASI had significantly higher risks of symptoms of prolapse, urge urinary incontinence, pain, dyspareunia and impacts on daily life.

Highlights

The aims of this study were to evaluate pelvic floor dysfunction symptoms one year after delivery and investigate whether adverse functional outcomes after childbirth were related to the degree of perineal injury
We evaluated pelvic floor function one year after birth in a nonselected cohort of primiparas and found that adverse functional outcomes were experienced in women with perineal lacerations of all grades as well as those with an intact perineum
Dyspareunia and urinary incontinence were the most common symptoms of pelvic floor dysfunction one year after childbirth. Those who suffered from obstetric anal sphincter injury (OASI) had a significantly higher risk of experiencing symptoms of prolapse, urinary urge incontinence, anal incontinence, dyspareunia and pain

Summary

Introduction

The aims of this study were to evaluate pelvic floor dysfunction symptoms one year after delivery and investigate whether adverse functional outcomes after childbirth were related to the degree of perineal injury. Women with OASI had significantly higher risks of symptoms of prolapse, urge urinary incontinence, pain, dyspareunia and impacts on daily life. An estimated 40–50% of lacerations involve the perineal muscles, and up to 7% of these women suffer from severe obstetric anal sphincter injury (OASI)[1,2]. The aims of this study were to evaluate symptoms of prolapse, urinary and anal incontinence, and perineal pain as well as sexual function one year after birth and investigate whether adverse functional outcomes were related to the degree of perineal injury. We hypothesized that the prevalence of symptoms of postpartum pelvic floor dysfunction would be related to the degree of perineal trauma

Objectives

Methods

Results

Conclusion