Postpartum impairment of pelvic floor muscle function: factors involved and association with prolapse

Abstract

The aim of this study is to assess factors involved in the impairment of pelvic floor muscle (PFM) function from antepartum to 6 months postpartum. We also investigated whether reduced PFM strength was associated with pelvic organ prolapse (POP) postpartum. This was a prospective cohort study including 319 primigravid women delivered vaginally. PFM function was assessed in pregnant women at term and 6 months postpartum by digital palpation and perineometry. Prolapse was explored using the POP quantification (POP-Q) system. Instrumental delivery, larger newborn head circumference, and older maternal age were independent risk factors for impaired PFM function postpartum. Women with POP-Q stage ≥ II postpartum had a significant decrease in PFM strength with respect to the antepartum period, and lower PFM strength than women without such prolapse. Both constitutional and obstetric factors are involved in impairment of PFM function postpartum. Reduced PFM strength is associated with prolapse in the postpartum period.