Postpartum impairment of pelvic floor muscle function: factors involved and association with prolapse

Int Urogynecol J. 2011 Dec;22(12):1505-11. doi: 10.1007/s00192-011-1484-2. Epub 2011 Jun 22.

Abstract

Introduction and hypothesis: The aim of this study is to assess factors involved in the impairment of pelvic floor muscle (PFM) function from antepartum to 6 months postpartum. We also investigated whether reduced PFM strength was associated with pelvic organ prolapse (POP) postpartum.

Methods: This was a prospective cohort study including 319 primigravid women delivered vaginally. PFM function was assessed in pregnant women at term and 6 months postpartum by digital palpation and perineometry. Prolapse was explored using the POP quantification (POP-Q) system.

Results: Instrumental delivery, larger newborn head circumference, and older maternal age were independent risk factors for impaired PFM function postpartum. Women with POP-Q stage ≥ II postpartum had a significant decrease in PFM strength with respect to the antepartum period, and lower PFM strength than women without such prolapse.

Conclusions: Both constitutional and obstetric factors are involved in impairment of PFM function postpartum. Reduced PFM strength is associated with prolapse in the postpartum period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Delivery, Obstetric / adverse effects
  • Female
  • Humans
  • Maternal Age
  • Middle Aged
  • Muscle Strength / physiology
  • Muscles / physiopathology*
  • Palpation
  • Pelvic Floor / physiopathology*
  • Pelvic Organ Prolapse / epidemiology
  • Pelvic Organ Prolapse / etiology*
  • Pelvic Organ Prolapse / physiopathology*
  • Postpartum Period / physiology*
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Young Adult