Article

The risk of stress incontinence 5 years after first delivery

Department of Obstetrics and Gynecology, Glostrup County Hospital, University of Copenhagen, Ndr. Ringvej 2600, Copenhagen, Denmark.
American Journal of Obstetrics and Gynecology (Impact Factor: 4.7). 08/2001; 185(1):82-7. DOI: 10.1067/mob.2001.114501
Source: PubMed

ABSTRACT

We aimed to evaluate the impact of a first pregnancy and delivery on the prevalence of stress incontinence 5 years afterward.
This longitudinal cohort study included 278 women who were questioned after their first delivery and again 5 years later.
The prevalence of stress incontinence 5 years after a first delivery was 30%, and the 5-year incidence was 19%. The risk of stress incontinence 5 years after a first delivery was related to the onset and duration of symptoms after the first pregnancy and delivery in a "dose-response-like" manner. The use of vacuum extraction or episiotomy during the first delivery increased the risk.
First pregnancy and delivery may result in stress incontinence 5 years later. Women with incontinence 3 months after a first delivery have a particularly high risk of long-lasting symptoms. Obstetric risk factors are vacuum extraction and episiotomy.

0 Followers
 · 
5 Reads
  • Source
    • "Pelvic floor disorder can lead to urinary incontinence [1] [2] [3], descent and prolapse of the pelvic organs, and fecal incontinence [1] [3] [4] [5]. In addition to delivery, other known risk factors include increased age of the woman in labor, parity, excess weight, and increased physical exertion [6] [7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: We compared the incidence and type of levator ani avulsion diagnosed by translabial ultrasound evaluation in primiparous women six months after vacuum-assisted or spontaneous vaginal delivery. Material and methods: This retrospective observational study was performed between January 2011 and December 2013. Primiparous women six months after vacuum-assisted vaginal delivery and after spontaneous vaginal delivery underwent translabial ultrasound evaluation. The distance between the urethra and fibers of the musculus levator ani puborectalis (levator–urethra gap) was measured. A levator-urethra gap >25 mm was considered a musculus levator ani avulsion. Results: In total, 184 women participated in the study. Among them, 92 had vacuum extraction and 92 had uncomplicated spontaneous delivery. A longer levator–urethra gap on both sides of the pubic bone was found in women after vacuum-assisted vaginal delivery (p < 0.0001 for both sides). Musculus levator ani avulsion was identified in 20 women (unilateral in 16 cases and bilateral in four cases). No difference in an incidence of musculus levator ani avulsion was identified in women after vacuum-assisted vaginal delivery [11/92 (12%)] compared to spontaneous delivery [9/92 (10%); p = 0.81]. Conclusion: Vacuum-assisted vaginal delivery in primiparous women is associated with a longer levator–urethra gap but not with a higher frequency of avulsion of the musculus levator ani.
    Full-text · Article · Oct 2015 · Journal of Maternal-Fetal and Neonatal Medicine
  • Source
    • "Pelvic floor disorder can lead to urinary incontinence [1] [2] [3], descent and prolapse of the pelvic organs, and fecal incontinence [1] [3] [4] [5]. In addition to delivery, other known risk factors include increased age of the woman in labor, parity, excess weight, and increased physical exertion [6] [7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: 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.
    Full-text · Article · Feb 2015 · Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
  • Source
    • "progressive et chronique des systè mes de soutè nement assurant la continence en cas de grossesse gé mellaire semble inté ressante. Les six facteurs associé s a ` l'IUE du post-partum dans notre e ´ tude sont des facteurs de risque reconnus dans la litté rature : obé sité [2] [3] [6], expression uté rine [2], duré e du travail supé rieure ou e ´ gale a ` huit heures [14], IUE du post-partum immé diat [3] [5], IUE pré natale [5] et poids de naissance [2]. Aucune e ´ tude n'a, a ` notre connaissance, e ´ valué l'impact de la gé mellité sur le risque de survenue d'une IUE en post-partum. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To study twin pregnancy and delivery as a risk factor for developing postpartum stress urinary incontinence (SUI).Patients and methodsRetrospective single centre study comparing 117 patients who have delivered twins to 117 patients who have given birth to singletons, between January 2003 and December 2005 in a tertiary maternal-foetal medicine unit. The risk factors associated with the onset of postpartum SUI, its severity, and its impact on the quality of life were studied.ResultsSixty patients in the twin pregnancy group and 59 in the singleton pregnancy group have answered an auto-questionnaire and were included in the study. The medium-term follow-up of the patient was 20.2 months ± 10.1. The prevalence of SUI in the total population was 30%. The rate was significantly higher in the “twin” group (40%) than in the “singleton” group (20%) (p = 0.03). Twin gestation was significantly associated with postpartum SUI for more than 20 months after delivery (OR = 2.6 [1.1–5.9]). The univariate analysis found six other risk factors: prenatal urinary incontinence (OR = 4.2 [1.7–10.4]), BMI greater than 30 (OR = 6.3 [1.2–34.1]), labour duration greater than 8 h (OR = 4.8 [1.6–14.5]), fundal uterine pressure (OR = 4.5 [1.1–18.3]), total intrauterine foetal weight (p = 0.003), and immediate postpartum urinary incontinence (OR = 12.9 [5–33.5]).Discussion and conclusionThe vaginal delivery of two successive foetuses does not seem more purveyor of SUI than caesarean. In twin pregnancies, the high rate of postpartum SUI appears to be related to total intrauterine weight.
    Full-text · Article · Apr 2010 · Gynécologie Obstétrique & Fertilité
Show more