Genital Prolapse and Urinary Incontinence After Childbirth

 

Grade of recommendation

Level of evidence

Actions before pregnancy

Stop smoking

B

2

Age (<35 at pregnancy)

A

2

Overweight reduction

A

2

Actions during pregnancy

Reducing constipation

B

2

Stop smoking

D

2, 3

Reducing caffeine

D

–

Crossed legs when coughing

D

–

Bladder training

D

–

Physical activity

B

1, 2

Pelvic floor muscle training

A

1

Restricted weight gain

D

2, 3

Perineal massage

D

–

Actions in association with delivery and postpartum

Pushing during second stage of labor

D

–

Avoid prolonged second stage of labor

D

2, 3

Restriction of epidural

D

–

Restrictive episiotomy

D

–

Avoid Sphincter tear

D

–

Delivery position

D

–

Restriction of vaginal delivery

D

–

Use of perineal warm packs

B

–

Cesarean section

D

1, 2, 3

Pelvic floor muscle training

A

1

Vaginal cones and electrical stimulation

D

–

Weight reduction (as prepregnancy in 6 months)

B

2

Reducing constipation

C

3




Table 11.2
Flowchart for primary prevention of PFD and to address to vaginal delivery or cesarean section according with risk factors

A325267_1_En_11_Tab2_HTML.gif




References



1.

Glazener C, Elders A, Macarthur C, Lancashire RJ, Herbison P, Hagen S, Dean N, Bain C, Toozs-Hobson P, Richardson K, McDonald A, McPherson G, Wilson D, ProLong Study Group (2013) Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse. BJOG 120(2):161–168CrossRefPubMed


2.

Leijonhufvud Å, Lundholm C, Cnattingius S, Granath F, Andolf E, Altman D (2012) Risk of surgically managed pelvic floor dysfunction in relation to age at first delivery. Am J Obstet Gynecol 207(4):303.e1–7CrossRef


3.

Elenskaia K, Thakar R, Sultan AH, Scheer I, Onwude J (2013) Effect of childbirth on pelvic organ support and quality of life: a longitudinal cohort study. Int Urogynecol J 24(6):927–937CrossRefPubMed


4.

Chaliha C (2009) Postpartum pelvic floor trauma. Curr Opin Obstet Gynecol 21:474–479CrossRefPubMed


5.

Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, DeLancey JO (2006) Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol 195(1):23–28, Epub 2006 Mar 30PubMedCentralCrossRefPubMed


6.

Durnea CM, Khashan AS, Kenny LC, Durnea UA, Smyth MM, O’Reilly BA (2014) Prevalence, etiology and risk factors of pelvic organ prolapse in premenopausal primiparous women. Int Urogynecol J 25:1463–1470CrossRefPubMed


7.

Klein MC (2012) Cesarean section on maternal request: a societal and professional failure and symptom of a much larger problem. Birth 39:305CrossRefPubMed


8.

Okonkwo NS, Ojengbede OA, Morhason-Bello IO, Adedokun BO (2012) Maternal demand for cesarean section: perception and willingness to request by Nigerian antenatal clients. Int J Womens Health 4:141PubMedCentralCrossRefPubMed

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May 5, 2017 | Posted by in GYNECOLOGY | Comments Off on Genital Prolapse and Urinary Incontinence After Childbirth

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