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Can pelvic floor injury secondary to delivery be prevented?

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Abstract

The number of women suffering from pelvic floor disorders (PFD) is likely to grow significantly in the coming years with a growing older population. There is an urgent need to investigate factors contributing to the development of PFD and develop preventative strategies. We have reviewed the literature and analyzed results from our own study regarding the association between delivery mode, obstetrical practice and fetal measurements, and damage to the pelvic floor. Based on our findings, we have suggested a flowchart helping the obstetrician to conduct vaginal delivery with minimal pelvic floor insult. Primiparity, instrumental delivery, large fetal head circumference, and prolonged second stage of delivery are risk factors for PFD. Pelvic floor integrity should always be seriously considered in every primiparous woman. All efforts should be aimed at minimizing any insult, which might have a significant impact on the woman’s pelvic integrity and future quality of life.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Hadassah Mount Scopus, Jerusalem, Israel

    Yuval Lavy, Chava I. Kaniel & Drorith Hochner-Celnikier

  2. Division of Urogynecology, NorthShore University HealthSystem, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Peter K. Sand

  3. Department of Obstetrics and Gynecology, Hadassah Hospital, Mount Scopus, Jerusalem, Israel

    Yuval Lavy

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  1. Yuval Lavy
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  2. Peter K. Sand
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  3. Chava I. Kaniel
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Correspondence to Yuval Lavy.

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Lavy, Y., Sand, P.K., Kaniel, C.I. et al. Can pelvic floor injury secondary to delivery be prevented?. Int Urogynecol J 23, 165–173 (2012). https://doi.org/10.1007/s00192-011-1530-0

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  • DOI: https://doi.org/10.1007/s00192-011-1530-0

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