HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sze, E. H. M. Articles by Dolezal, J. M. Search for Related Content PubMed PubMed Citation Articles by Sze, E. H. M. Articles by Dolezal, J. M.

Pregnancy, Labor, Delivery, and Pelvic Organ Prolapse

From the Departments of Obstetrics & Gynecology and Surgery, East Carolina University Brody School of Medicine, Pitt County Memorial Hospital, Greenville, North Carolina.

Address reprint requests to: Eddie H. M. Sze, MD, Yale University School of Medicine, Department of Obstetrics and Gynecology, 333 Cedar Street, PO Box 208063, New Haven, CT 06520; E-mail: eddie.sze{at}yale.edu.

OBJECTIVE: To compare 1) the occurrence of pelvic organ prolapse after vaginal and cesarean delivery, and 2) the susceptibility of black and white women to developing prolapse during childbirth.

METHODS: Ninety-four nulliparous women were evaluated for pelvic organ prolapse at their 36-week antepartum and 6-week postpartum visits using the International Continence Society staging system. A change in International Continence Society stage from 36 weeks antepartum to 6 weeks postpartum was considered pelvic organ prolapse that developed during childbirth.

RESULTS: Forty-three (46%) of 94 nulliparous women had pelvic organ prolapse at their 36-week antepartum visit. Twenty-four (26%) had a stage II prolapse. Six weeks postpartum, 13 of 41 (32%) who had spontaneous vaginal delivery and nine of 26 (35%) who had cesarean delivery during active labor developed a new prolapse (P = .805). Seven (17%) who had spontaneous vaginal delivery and two (8%) who had cesarean delivery during active labor revealed a more severe prolapse (P = .237). Eighteen (33%) of 54 black and 17 (43%) of 40 white women developed a new prolapse during childbirth (P = .363). Eight (15%) black and six (15%) white women revealed a more severe prolapse (P = .980).

CONCLUSION: Our data suggest that elective cesarean is only partially effective in preventing pelvic organ prolapse. Cesarean delivery during active labor and vaginal delivery had a similar effect on the maternal pelvic support. This indicates that prolapse developed during the first and not the second stage of labor. Black women are as susceptible to developing prolapse during childbirth as their white counterparts.

This article has been cited by other articles:

				C. S. Bradley, I. E. Nygaard, and for the Women's Health Initiative (WHI) Vaginal Wall Descensus and Pelvic Floor Symptoms in Older Women Obstet. Gynecol., October 1, 2005; 106(4): 759 - 766. [Abstract] [Full Text] [PDF]

				J. M. Montella Vaginal Mullerian Cyst Presenting as a Cystocele Obstet. Gynecol., May 1, 2005; 105(5): 1182 - 1184. [Abstract] [Full Text] [PDF]

				G. W. Cundiff An 80-Year-Old Woman With Vaginal Prolapse JAMA, April 27, 2005; 293(16): 2018 - 2027. [Full Text] [PDF]

				I. Nygaard, C. Bradley, and D. Brandt Pelvic Organ Prolapse in Older Women: Prevalence and Risk Factors Obstet. Gynecol., September 1, 2004; 104(3): 489 - 497. [Abstract] [Full Text] [PDF]

				L. R. Berkowitz Case 20-2004 - A 46-Year-Old Woman with Pelvic-Floor Relaxation after a Second Vaginal Delivery N. Engl. J. Med., June 24, 2004; 350(26): 2699 - 2706. [Full Text] [PDF]