Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Childbirth Delivery Mode & Pelvic Floor Disorders

JAMA; 2018 Dec 18; Blomquist, Muñoz, et al

The risk of pelvic floor disorders varies by delivery mode after childbirth, with cesarean delivery presenting a lower risk compared to vaginal delivery, a recent study found. In the cohort of 1,528 women, researchers described the incidence of pelvic floor disorders after childbirth and identified maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery. Participants were categorized into the following mode of delivery groups: cesarean birth, spontaneous vaginal birth (≥1 spontaneous vaginal delivery and no operative vaginal deliveries), or operative vaginal birth (≥operative vaginal delivery). Among the findings:

  • Compared with spontaneous vaginal delivery, cesarean delivery was associated with significantly lower hazard for stress urinary incontinence, overactive bladder, and pelvic organ prolapse.
  • Operative vaginal delivery was associated with significantly higher hazard of anal incontinence and pelvic organ prolapse.
  • A larger genital hiatus size was associated with increased risk of pelvic organ prolapse independent of delivery mode.

Citation:

Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA. 2018;320(23):2438–2447. doi:10.1001/jama.2018.18315.

This Week's Must Reads

Inflammatory Cytokines & Perinatal Depression, Am J Obstet Gynecol; ePub 2018 Dec 14; Miller, et al

Childbirth Delivery Mode & Pelvic Floor Disorders, JAMA; 2018 Dec 18; Blomquist, Muñoz, et al

Chronic Disease Risk with Vaginal Estrogen Use, Menopause; ePub 2018 Dec 17; Bhupathiraju, et al

Robotic-Assisted Gynecologic Surgery in Elderly Patients, Am J Obstet Gynecol; ePub 2018 Dec 14; Madden, et al

Fertility Treatment and Breastfeeding Outcomes , Am J Obstet Gynecol; ePub 2018 Dec 1; Barrera, et al

Must Reads in Pelvic Floor Dysfunction

Childbirth Delivery Mode & Pelvic Floor Disorders, JAMA; 2018 Dec 18; Blomquist, Muñoz, et al

Patient Perceptions on AEs after PFD Surgery, Am J Obstet Gynecol; ePub 2018 Oct 26; Dunivan, et al

Combined Gynecologic Ca & Pelvic Floor Dysfunction Surgery, Female Pelvic Med Reconstr Surg; ePub 2018 Oct 22; McConnell, et al

Opioid Prescribing After Surgery for Pelvic Organ Prolapse, Female Pelvic Med Reconstr Surg; ePub 2018 Sep 22; Leach, et al

Pelvic Floor Disorders Knowledge in Pregnant Women, Female Pelvic Med Reconstr Surg; ePub 2018 Aug 2; Mckay, et al