Rate of pelvic organ prolapse in Maternity Teaching Hospital in Erbil city

Abstract

The present study is carried out to describe the prevalence rate of pelvic organ prolapse (POP) among women in Erbil city and to compare the outcomes between normal vaginal delivery and cesarean section. It also aims to find out the risk factors associated with POP. This study is a cross-sectional observational study carried out in Maternity Teaching Hospital in Erbil city, Kurdistan region, north of Iraq from 1 st April 2015 to 1 st April 2016. It includes all married women aged between 15-80 years both nulliparous and multiparous, excluding pregnant women and those in perpurium period in addition to those who underwent previous POP surgery. The data collected by using standardized POP-Q system and the results were analyzed using SPSS computer software version 23.0, Chi-square test; the results were considered significant at p<0.05. 510 women participated in this study aged between 15-80 years. The prevalence of POP was 90.2% in general. The POP rates for 372 cases who have delivered vaginally and 88 cases with cesarean section operation deliveries were 92.1% and 77.3%, respectively. Generally among those 90.2% of the cases who have prolapse, 32.9% have only anterior vaginal wall prolapse, 2% of them have only posterior vaginal wall prolapse, 52.9% have both anterior and posterior vaginal wall prolapse and 2.4% have all the types of prolapse at the same time (anterior, posterior and uterine). The overall distribution of POP stages were: stage zero (9.8%), 1 st stage (26.3%), 2 nd stage (39.2%), 3 rd stage (1.2%), 4 th stage (2.4%) and (21.2%) have combined stage of prolapse (1 st and 2 nd stage in those who have anterior and posterior type prolapse together at the same time). Findings of the study showed that POP is very common among women and is more so among those women who delivered vaginally than those delivered by cesarean section; those who delivered by cesarean section have a fewer degree of prolapse. The common type of prolapse was anterior vaginal prolapse and 2 nd stage prolapse was the prevailed one. The most important risk factors were age, a high number of vaginal deliveries, occupation, history of an overweight baby, short birth gap space and low social economic state.