Trajectories of Pelvic Floor Symptoms and Support After Vaginal Delivery in Primiparous Women Between Third Trimester and 1 Year Postpartum

Objective The aim of this prospective study is clinical and ultrasonographic evaluation of the pelvic floor in primiparous women after normal vaginal delivery with episiotomy and without episiotomy. Methods This is a cross-section study of primiparous women with a history of delivery at Tanta University Hospital from August 2018 to August 2019. The sample power was calculated based on avulsion (major and minor) in two groups (vaginal delivery with episiotomy and without episiotomy) of total forty-primiparous women with an interval after delivery (20 cases after normal vaginal delivery with episiotomy and 20 cases after normal vaginal delivery without episiotomy). Results Twenty-four hours of delivery there was a highly significant difference between group A (with episiotomy) and group B (without episiotomy) regarding to ultrasound abnormalities, degree of tear, blood loss, hemoglobin concentration and clinical findings, while no difference regarding levator ani weakness. Two months later from delivery there was no significant difference between group A and group B regarding to ultrasound abnormalities and levator ani weakness while there was a difference between the two groups in regarding with clinical findings. Conclusion Normal vaginal delivery without episiotomy in primiparous women is better than normal vaginal delivery with episiotomy as there is no perineal tenderness, no dyspareunia. Low incidence of urinary, rectal incontinence, tear and perineal infection.

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Pelvic floor biometry in asymptomatic primiparous women compared with nulliparous women: a single-center study in Southern China

Journal of International Medical Research ◽

10.1177/0300060520920393 ◽

2020 ◽

Vol 48 (4) ◽

pp. 030006052092039

Author(s):

Yong-jiang Mao ◽

Zhi-juan Zheng ◽

Jie-hua Xu ◽

Jing Xu ◽

Xin-ling Zhang

Keyword(s):

Cesarean Section ◽

Pelvic Floor ◽

Vaginal Delivery ◽

Southern China ◽

Valsalva Maneuver ◽

Elective Cesarean Section ◽

Nulliparous Women ◽

Elective Cesarean ◽

Primiparous Women ◽

Ultrasound Parameters

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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