Abstract
The purpose of this study was to evaluate pelvic organ support during pregnancy and following delivery. This was a prospective observational study. Pelvic organ prolapse quantification (POPQ) examinations were performed during each trimester of pregnancy and in the postpartum. Statistical comparisons of POPQ stage and of the nine measurements comprising the POPQ between the different time intervals were made using Wilcoxon’s signed rank and the paired t-test. Comparison of POPQ stage by mode of delivery was made using Fisher’s exact test. One hundred thirty-five nulliparous women underwent 281 pelvic organ support evaluations. During both the third trimester and postpartum, POPQ stage was significantly higher compared to the first trimester (p<0.001). In the postpartum, POPQ stage was significantly higher in women delivered vaginally compared to women delivered by cesarean (p=0.02). In nulliparous pregnant women, POPQ stage appears to increase during pregnancy and does not change significantly following delivery. In the postpartum, POPQ stage may be higher in women delivered vaginally compared to women delivered by cesarean.
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The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense. Reprints will not be available
Editorial Comment: The authors have performed a perspective observational study on pregnant women and performed POPQ examinations in each trimester and postpartum. The POPQ stage differed significantly between the first and third trimesters and between the first trimester and postpartum. No change was observed between the third trimester and postpartum. The mode of delivery was also recorded and there was no significant change in the POPQ examination of patients who delivered vaginally as compared to cesarean section. However, all the patients who underwent a cesarean section were in labor and the numbers are fairly low. The authors conclude that pregnancy itself is a risk factor in the development of pelvic floor disorders. This study is limited by its size and by the fact that an examination was not done in each trimester of the pregnancy in order to assess the progression of the pelvic floor disorder. It is however an interesting and useful study that may affect the debate on elective cesarean section for the prevention of pelvic floor disorders.
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O’Boyle, A.L., O’Boyle, J.D., Calhoun, B. et al. Pelvic organ support in pregnancy and postpartum. Int Urogynecol J 16, 69–72 (2005). https://doi.org/10.1007/s00192-004-1210-4
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DOI: https://doi.org/10.1007/s00192-004-1210-4