Obstetric antecedents for postpartum pelvic floor dysfunction
Obstetric antecedents for postpartum pelvic floor dysfunction
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DOI：
10.1016/j.ajog.2004.11.031
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发表时间：
2005-05-01
影响因子：
9.8
通讯作者：
Leveno, KJ
中科院分区：
文献类型：
--
作者：
Casey, BM;Schaffer, JI;Leveno, KJ
目的：本研究的目的是前瞻性地评估选定的产科前因和盆底功能障碍的症状之间的关联在preparous妇女长达7个月后birthedesignation.Study设计：2000年6月1日和2002年8月31日之间交付的所有未经产的妇女，有资格接受产后采访的持续性盆底功能障碍的症状。对所有在6个月避孕随访时或之前完成调查的妇女的回答进行了分析。产科前因的压力，紧迫，肛门失禁，并为每个因素的归因风险calculated.Results：在研究期间，3887 10,643产妇（37%）返回219天内交付。压力性尿失禁和急迫性尿失禁的症状在接受剖腹产的妇女中显著减少（P <0.01）。在接受产钳分娩的妇女中，急迫性尿失禁的症状增加了一倍（P = 0.04）。分娩体重> 4000 g婴儿的妇女肛门失禁症状增加（P = .006），并且在接受催产素并进行会阴切开术的女性中增加了一倍以上结论：在分娩后7个月内出现骨盆底功能障碍症状的可能性在接受催产素的妇女中更大，分娩体重> 4000 g的婴儿或进行外阴切开术的患者。接受剖腹产的妇女有更少的急迫性和压力性尿失禁的症状。(c)2005年爱思唯尔公司All rights reserved.
Objective: The purpose of this study was to evaluate prospectively the association between selected obstetric antecedents and symptoms of pelvic floor dysfunction in primiparous women up to 7 months after childbirth.Study design: All nulliparous women who were delivered between June 1, 2000, and August 31, 2002, were eligible for a postpartum interview regarding symptoms of persistent pelvic floor dysfunction. Responses from all women who completed a survey at or before their 6-month contraceptive follow-up visit were analyzed. Obstetric antecedents to stress, urge, and anal incontinence were identified, and attributable risks for each factor were calculated.Results: During the study period, 3887 of 10,643 primiparous women (37%) returned within 219 days of delivery. Symptoms of stress and urge urinary incontinence, were significantly reduced (P < .01) in women who underwent a cesarean delivery. Symptoms of urge urinary incontinence doubled in women who underwent a forceps delivery (P = .04). Symptoms of anal incontinence were increased in women who were delivered of an infant who weighed > 4000 g (P = .006) and more than doubled in those women who received oxytocin and had an episiotomy performed (P = .01).Conclusion: The likelihood of symptoms of pelvic floor dysfunction up to 7 months after delivery was greater in women who received oxytocin, who underwent a forceps delivery, who were delivered of an infant who weighed > 4000 g, or who had an episiotomy performed. Women who underwent a cesarean delivery had fewer symptoms of urge and stress urinary incontinence. (c) 2005 Elsevier Inc. All rights reserved.