Open AccessRelation between vaginal birth and pelvic organ prolapse
Author(s) -
SZE EDDIE H.M.,
HOBBS GERRY
Publication year - 2009
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340802596033
Subject(s) - medicine , vaginal birth , gynecology , obstetrics , odds ratio , stage (stratigraphy) , population , pregnancy , paleontology , genetics , environmental health , biology
Objective. To evaluate the relation between vaginal birth and pelvic organ prolapse quantification (POPQ) stages III and IV prolapse and whether each additional vaginal birth is associated with an increase in pelvic support defects. Design. Prospective cross‐sectional study. Setting. Gynecology clinic in a University Hospital. Population: Four hundred and fifty‐eight nulliparas and 892 multiparas, including 272 with one, 299 with two and 321 with at least three term vaginal deliveries. Methods. In a Human Investigation Committee approved‐study, the pelvic support of nulliparas and multiparas who only had term vaginal deliveries was evaluated for prolapse using the POPQ system. Main outcome measure. 1. Difference in POPQ stages III and IV prolapse between nulliparas and multiparas. 2. Difference in POPQ stage distribution among nulliparas and multiparas who had one, two, and at least three term vaginal deliveries. Results. Compared with nulliparas, the odds ratios of having POPQ stage II defect and stage III or IV prolapse associated with multiparas was 2.95 (95% CI: 2.06–4.24) and 1.01 (95% CI: 0.40–2.79), respectively. The prevalence of POPQ stage II defect among nulliparas and multiparas that had one, two, and at least three term vaginal deliveries was 25% (119/458), 50% (137/272), 66% (198/299), and 69% (220/321), respectively ( p <0.001), while 1% (6/458), 1% (4/272), 2% (7/299), and 2% (8/321), respectively, had POPQ stage III or IV prolapse ( p = 0.618). Conclusions. Vaginal birth is not associated with POPQ stages III and IV prolapse, but it is associated with an increase in POPQ stage II defect.