Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study

Summary Objective To describe changes in pelvic organ support from mid pregnancy until 1 year postpartum among nulliparous pregnant women, and to examine whether delivery route affects changes in pelvic organ support. Design Prospective cohort study. Setting Akershus University Hospital in Norway. P...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2016-04, Vol.123 (5), p.821-829
Main Authors: Reimers, C, Stær‐Jensen, J, Siafarikas, F, Saltyte‐Benth, J, Bø, K, Ellström Engh, M
Format: Article
Language:English
Subjects:
Adult
Delivery
Delivery, Obstetric - adverse effects
Delivery, Obstetric - methods
Female
Humans
Linear Models
Longitudinal Studies
Norway
Pelvic Floor - physiopathology
Pelvic Organ Prolapse - diagnosis
Pelvic Organ Prolapse - epidemiology
Pelvic Organ Prolapse - etiology
pelvic organ support
POP
postpartum
Postpartum period
Pregnancy
Pregnancy Complications - diagnosis
Pregnancy Complications - epidemiology
Pregnancy Complications - etiology
Prevalence
primipara
Prospective Studies
Puerperal Disorders - diagnosis
Puerperal Disorders - epidemiology
Puerperal Disorders - etiology
Risk Factors
Studies
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Summary:Summary Objective To describe changes in pelvic organ support from mid pregnancy until 1 year postpartum among nulliparous pregnant women, and to examine whether delivery route affects changes in pelvic organ support. Design Prospective cohort study. Setting Akershus University Hospital in Norway. Population A cohort of 300 nulliparous pregnant women included at mid‐pregnancy. Methods Pelvic organ support assessed at 21 and 37 weeks of gestation, and again at 6 weeks, 6 months, and 12 months postpartum, by the use of the Pelvic Organ Prolapse Quantification (POP‐Q) system. Linear mixed model was used to assess longitudinal change in pelvic organ support. Main outcome measures Prevalence of anatomic POP. Change in POP‐Q variables over time and between delivery groups. Results The prevalence of anatomic POP ranged from 0 to 10%. Vaginal POP‐Q points made a cranial shift from mid to late pregnancy, a caudal shift following delivery, and again a cranial shift after 6 weeks postpartum. Postpartum change was present following both vaginal and caesarean deliveries, but was more pronounced following vaginal delivery. The perineal body and genital hiatus became longer from mid to late pregnancy, and shortened after 6 weeks postpartum. At 12 months postpartum all POP‐Q points, except cervix, had recovered to baseline in the vaginal delivery group. Conclusions The prevalence of anatomic POP was low in this cohort. There was change in pelvic organ support both during pregnancy and following vaginal as well as caesarean delivery. The short‐term ability to recover was good after the first pregnancy and delivery. Tweetable Pelvic organ support changes during pregnancy. A contribution to the risk of POP? Tweetable Pelvic organ support changes during pregnancy. A contribution to the risk of POP?
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.13432