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25-09-2021 | Perineal Laceration | Original Article

Pelvic floor dysfunction after vaginal delivery: MOODS—a prospective study

Authors: Ana Catarina Borges, Natacha Sousa, Rita Sarabando, Catarina Vieira, Bárbara Ribeiro, Paulina Barbosa, Alexandra Miranda, Isabel Reis, Cristina Nogueira-Silva

Published in: International Urogynecology Journal | Issue 6/2022

Abstract

Introduction and hypothesis

Labor is a known risk factor for pelvic floor dysfunction (PFD); however, the impact of operative vaginal delivery (OVD), particularly spatulas, remains unclear. The aim of this study was to compare postpartum PFD symptoms in women undergoing spontaneous vaginal delivery (SVD) and those undergoing OVD.

Methods

An observational prospective study (MOODS: Maternal-neonatal Outcomes in Operative Vaginal Delivery) was enrolled at Hospital de Braga from February to October 2018. All singleton term OVD (Thierry spatulas and vacuum extractor) and a convenience SVD sample were recruited, in a 2:1 ratio. To assess PFD symptoms Pelvic Floor Distress Inventory-20 (PFDI-20) was applied at 3, 6, and 12 months postpartum. The questionnaire is divided into three subscales: Urinary (UDI), Colorectal-Anal (CRADI), and Pelvic Organ Prolapse Distress Inventory (POPDI).

Results

Of the 304 women recruited, 207 were included, 34.3% with SVD and 65.7% with OVD. Thierry spatulas were used in 53.7% of women undergoing OVD. Frequency of nulliparous (p < 0.001), episiotomy (p < 0.001), neuraxial anesthesia (p < 0.001), postpartum pain (p = 0.001) and occiput-posterior fetal position (p < 0.001) were significantly higher in OVD. Second phase of labor duration was longer in OVD (p = 0.001). At 3 months postpartum, women undergoing OVD and spatula-assisted delivery had higher UDI score, POPDI score, and global score, with no differences at 6 months and 1 year. After controlling for confounding variables, OVD and spatulas were still associated with greater POPDI scores at 3 months postpartum.

Conclusions

Operative vaginal delivery, particularly with spatulas, seems to be associated with a higher prevalence of early PFD symptoms, mainly regarding pelvic organ prolapse.

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Title: Pelvic floor dysfunction after vaginal delivery: MOODS—a prospective study
Authors: Ana Catarina Borges
Natacha Sousa
Rita Sarabando
Catarina Vieira
Bárbara Ribeiro
Paulina Barbosa
Alexandra Miranda
Isabel Reis
Cristina Nogueira-Silva
Publication date: 25-09-2021
Publisher: Springer International Publishing
Keywords: Perineal Laceration
Episiotomy
Published in: International Urogynecology Journal / Issue 6/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04982-w

At a glance: The STEP trials

Springer Medicine

Pelvic floor dysfunction after vaginal delivery: MOODS—a prospective study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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