Should women be offered elective cesarean section in the hope of preserving pelvic floor function?

Objective This study aimed to investigate pelvic floor biometry of asymptomatic primiparous women compared with nulliparous women by using four-dimensional transperineal ultrasound (4D TPUS). Methods From July 2015 to February 2017, 722 women were enrolled and divided into the nulliparous group (n = 292), the vaginal delivery group (n = 272), and the elective cesarean section group (n = 158). The ultrasound parameters of 4D TPUS were compared among the groups. Results The vaginal delivery group had a significantly greater bladder neck descent (η2 = 0.04), retrovesical angles on Valsalva maneuver (η2 = 0.01), urethral rotation (η2 = 0.01), levator hiatus area on Valsalva maneuver (η2 = 0.02), urethral inclination angle (η2 = 0.02), and funneling of the proximal urethra (η2 = 0.11) than the other two groups. Comparison of the two modes of delivery (vaginal delivery and cesarean section) also showed significant differences in the above-mentioned ultrasound parameters. Conclusion There are significant differences in pelvic floor biometry between asymptomatic primiparous women and nulliparous women, as well as between women with vaginal delivery and those with elective cesarean section.

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Volume sonography of the pelvic floor in nulliparous women and after elective cesarean section

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1080/j.1600-0412.2001.800705.x ◽

2001 ◽

Vol 80 (7) ◽

pp. 611-615 ◽

Cited By ~ 14

Author(s):

Nadin Ochsenbein ◽

Juozas Kurmanavicius ◽

Renate Huch ◽

Albert Huch ◽

Josef Wisser

Keyword(s):

Cesarean Section ◽

Pelvic Floor ◽

Elective Cesarean Section ◽

Nulliparous Women ◽

Elective Cesarean

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Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/s1516-31802013000100019 ◽

2013 ◽

Vol 131 (2) ◽

pp. 95-99 ◽

Cited By ~ 13

Author(s):

Angélica Mércia Pascon Barbosa ◽

Gabriela Marini ◽

Fernanda Piculo ◽

Cibele Vieira Cunha Rudge ◽

Iracema Mattos Paranhos Calderon ◽

...

Keyword(s):

Urinary Incontinence ◽

Cesarean Section ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Cross Sectional Study ◽

Elective Cesarean Section ◽

Muscle Dysfunction ◽

Cross Sectional ◽

Elective Cesarean ◽

Weight Gain During Pregnancy

CONTEXT AND OBJECTIVE There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. DESIGN AND SETTING Cross-sectional study, conducted in a public university. METHODS 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. RESULTS The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. CONCLUSION Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

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Nitrous oxide anxiolysis for elective cesarean section

Yearbook of Anesthesiology and Pain Management ◽

10.1016/s1073-5437(08)70173-6 ◽

2007 ◽

Vol 2007 ◽

pp. 196-198

Author(s):

D.H. Chestnut

Keyword(s):

Nitrous Oxide ◽

Cesarean Section ◽

Elective Cesarean Section ◽

Elective Cesarean

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Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i1.173 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Danielle Levin

Keyword(s):

Single Dose ◽

Case Report ◽

Cesarean Section ◽

Epidural Anesthesia ◽

Elective Cesarean Section ◽

Single Administration ◽

Dystonic Reaction ◽

Elective Cesarean ◽

Combined Spinal Epidural Anesthesia ◽

Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia. During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron. Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive. Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds. Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission.

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