Vaginal Delivery Increase Risk of Pelvic Prolapse

Women who give birth vaginally are at increased risk of developing pelvic organ prolapse during the first year after delivery, according to a new study.

Researchers at Yale University (New Haven, CT, USA) and Wenzhou Third People's Hospital (WZMC; Zhejiang, China) conducted a study that evaluated 110 women at the obstetrics clinic at WZMC, who were in their 36th–38th week of pregnancy between April and May 2009, and were planning to undergo an elective C-section or vaginal delivery. The researchers compared changes in pelvic organ prolapse during late pregnancy and at three different points in time within one year after delivery.

The results showed that many women developed moderate prolapse in late pregnancy; however, women who underwent vaginal delivery or C-section after laboring were less likely to recover from pelvic organ prolapse at six weeks, six months, and one year postpartum, compared to those who delivered after an elective C-section with no labor. The results also suggested that higher first-trimester body mass index (BMI) appear to predict long-term pelvic organ prolapse. The study was published in the July 2013 issue of the British Journal of Obstetrics and Gynaecology.

“The choice between vaginal birth and C-section is a complex one, and our results are not meant to promote one over the other,” said lead author Marsha Guess, MD, of the department of obstetrics, gynecology, and reproductive sciences at Yale school of medicine. “Our study is among the few that provide information about short- and long-term effects of labor and route of delivery on pelvic floor support to determine if and when recovery of pelvic floor support structures occurs over long durations of time.”

Pelvic organ prolapse is common among women who have given birth vaginally, due to hormonal changes, increased pressure, and the baby's passage through the birth canal, which can damage connective tissue, muscles, nerves, and blood vessels. The vagina and the surrounding organs relax, lose their support, and fall from their normal positions, leading to a host of complications such as urinary incontinence and bowel control. It is thought that some women are genetically predisposed to having an abnormal repair process after delivery, which may also contribute to pelvic organ prolapse.

Related Links:
Yale University
Wenzhou Third People's Hospital