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International Urogynecology Journal

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01-03-2018 | Original Article

The impact of childbirth on pelvic floor morphology in primiparous Black South African women: a prospective longitudinal observational study

Authors: Zeelha Abdool, Barend G. Lindeque, Hans P. Dietz

Published in: International Urogynecology Journal | Issue 3/2018

Abstract

Introduction and hypothesis

There is a lack of prospective studies evaluating the impact of childbirth on the pelvic floor in non-white populations. We intended to study delivery-related changes in pelvic floor morphology in Black South African primiparae. We also intended to determine the impact of anatomical changes on symptoms in the postpartum period.

Methods

A total of 153 nulliparous women between 35 and 39 weeks gestation were recruited from a district antenatal clinic. All women had a standardized interview, completed the International Consultation on Incontinence Vaginal Symptoms questionnaire followed by three/four dimensional transperineal ultrasonography. This was repeated at 3–6 months postpartum.

Results

Of the 153 women, 84 (54.9%) returned at a mean of 4.8 months postpartum. Of these women, 60 (71.4%) had a vaginal delivery and the remainder a caesarean section (20 emergency and 4 elective). Overall, there were statistically significant increases in bladder neck descent (P = 0.003), pelvic organ descent and levator hiatal distensibility (all P < 0001) at the postpartum assessment. Levator avulsion was diagnosed in nine (15%) of those delivered vaginally. Postpartum vaginal laxity was the commonest bothersome vaginal symptom, reported by 51 women (60.7%).

Conclusions

There is significant alteration in pelvic organ support and levator hiatal distensibility postpartum, with more marked effects in women after vaginal delivery. Of Black primiparous women, 15% sustained levator trauma after their first vaginal delivery.

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Title: The impact of childbirth on pelvic floor morphology in primiparous Black South African women: a prospective longitudinal observational study
Authors: Zeelha Abdool
Barend G. Lindeque
Hans P. Dietz
Publication date: 01-03-2018
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 3/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3530-1

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Springer Medicine

The impact of childbirth on pelvic floor morphology in primiparous Black South African women: a prospective longitudinal observational study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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