Journal de la science cellulaire et de la thérapie
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Abstrait

Delivery Mode and Pelvic Floor Disfunction

Vito Leanza, Vizzini Stefania, Gianluca Leanza and Carlo Pafumi

Introduction: Pelvic floor disorders compromise quality of life for a lot of women of all ages. The prevalence of urinary incontinence (UI) is thought to range from 17 to 45% among adult women. The etiology is thought to be multifactorial. Traumatic damage to fascial and muscular support structures during childbirth may be, an important contributor to the development of UI and prolapse of pelvic organ (POP). The aim of this study is to consider the association between delivery mode and pelvic floor disorders (POP and UI) Materials and methods: A review of the literature was undertaken using the Medline and Popline CD Rom considering articles published from 1996 to 2011; additional sources were identified from references cited in relevant research articles. We studied articles concerning stress urinary incontinence, pregnancy, childbirth, pelvic prolapse were considered. Conclusion: Literature research confirms that anatomic and functional damages are linked with obstetric factors. Pregnancy may cause urinary incontinence and prolapse. However vaginal delivery is associated with a significant higher risk of urinary incontinence and pelvic defects. Caesarean section may protect from perineal risk of delivery but not from the damage due to the pregnancy itself. During pregnancy UI ranges from 31 to 39%, in post-partum ranges from 24,5 to 29% and from 5 to 8% after vaginal and caesarean respectively. Pelvic floor disorders ranges from 21 to 36% after instrumental operative delivery and from 9 to 21% in vaginal spontaneous delivery. Forceps is found out the most dangerous instrument for pelvic floor, followed by vacuum and vaginal delivery with tears. The consequences of a traumatic delivery affect quality of life and increasing late damages have to be considered.