The management of urogynaecological problems in pregnancy and the early postpartum period

Abstract

Key content Lower urinary tract infection is associated with increased maternal and fetal morbidity. There is an association between pelvic organ prolapse and increasing parity and vaginal deliveries. Lower urinary tract dysfunction and pelvic organ prolapse are common during pregnancy and the postpartum period, but often resolve. Special consideration is needed regarding the management of lower urinary tract dysfunction and pelvic organ prolapse during pregnancy and the postpartum period, with an emphasis on conservative management. Learning objectives To know how to manage lower urinary tract infection in pregnancy. To understand the epidemiology and management of lower urinary tract dysfunction in pregnancy. To be aware of the epidemiology and management of pelvic organ prolapse in pregnancy. Ethical issues Should pregnant women be prescribed antimuscarinic drugs when adverse effects on the fetus have been shown in animal studies? Should women who have not completed their families be offered surgery for pelvic organ prolapse? Should elective caesarean section be offered to women who have had previous successful incontinence surgery?