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01-08-2016 | Original Article

Perineal body stretch during labor does not predict perineal laceration, postpartum incontinence, or postpartum sexual function: a cohort study

Authors: Kate V. Meriwether, Rebecca G. Rogers, Gena C. Dunivan, Jill K. Alldredge, Clifford Qualls, Laura Migliaccio, Lawrence Leeman

Published in: International Urogynecology Journal | Issue 8/2016

Abstract

Introduction and hypothesis

The perineum stretches naturally during obstetrical labor, but it is unknown whether this stretch has a negative impact on pelvic floor outcomes after a vaginal birth (VB). We aimed to evaluate whether perineal stretch was associated with postpartum pelvic floor dysfunction, and we hypothesized that greater perineal stretch would correlate with worsened outcomes.

Methods

This was a prospective cohort study of primiparous women who had a VB. Perineal body (PB) length was measured antepartum, during labor, and 6 months postpartum. We determined the maximum PB (PB_max) measurements during the second stage of labor and PB change (ΔPB) between time points. Women completed functional questionnaires and had a Pelvic Organ Prolapse Quantification (POP-Q) system exam 6 months postpartum. We analyzed the relationship of PB measurements to perineal lacerations and postpartum outcomes, including urinary, anal, and fecal incontinence, sexual activity and function, and POP-Q measurements.

Results

Four hundred and forty-eight women with VB and a mean age of 24 ± 5.0 years with rare (5 %) third- or fourth-degree lacerations were assessed. During the second stage of labor, 270/448 (60 %) had perineal measurements. Mean antepartum PB length was 3.7 ± 0.8 cm, with a maximum mean PB length (PB_max) during the second stage of 6.1 ± 1.5 cm, an increase of 65 %. The change in PB length (ΔPB) from antepartum to 6 months postpartum was a net decrease (−0.39 ± 1.02 cm). PB change and PB_max were not associated with perineal lacerations or outcomes postpartum (all p > 0.05).

Conclusions

PB stretch during labor is unrelated to perineal laceration, postpartum incontinence, sexual activity, or sexual function.

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Title: Perineal body stretch during labor does not predict perineal laceration, postpartum incontinence, or postpartum sexual function: a cohort study
Authors: Kate V. Meriwether
Rebecca G. Rogers
Gena C. Dunivan
Jill K. Alldredge
Clifford Qualls
Laura Migliaccio
Lawrence Leeman
Publication date: 01-08-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 8/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-2959-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perineal body stretch during labor does not predict perineal laceration, postpartum incontinence, or postpartum sexual function: a cohort study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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