IMR Press / CEOG / Volume 51 / Issue 1 / DOI: 10.31083/j.ceog5101020
Open Access Original Research
Delivery Mode and the Pelvic Floor Function of Primiparous Women at Early Postpartum: An Observational Retrospective Cohort Study
Xiaolei Chi1,2,†Lin Wen3,†Lan Chen1,2Hongxia Zhu1,2,*
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1 Department of Gynaecology, The International Peace Maternal and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, China
2 Shanghai Key Laboratory of Embryo Original Diseases, 200030 Shanghai, China
3 Department of Gynaecoloy, Jiading Branch of Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 201803 Shanghai, China
*Correspondence: zhuhongxia123@163.com (Hongxia Zhu)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2024, 51(1), 20; https://doi.org/10.31083/j.ceog5101020
Submitted: 6 August 2023 | Revised: 18 October 2023 | Accepted: 6 November 2023 | Published: 17 January 2024
(This article belongs to the Special Issue Delivery and Pelvic Floor Disorders)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Different modes of delivery are strongly associated with postpartum pelvic floor muscle (PFM) injury and postpartum pelvic floor dysfunction. This study used Glazer PFM surface electromyography (sEMG) to objectively assess postpartum PFM function to determine the effects of different modes of delivery on pelvic floor function in the early postpartum period in primiparous women. Methods: There were 1286 cases of cesarean delivery (CD) and 2099 cases of vaginal delivery (VD). The vaginal delivery group was further divided into four subgroups (A: intact perineum without laceration and first-degree laceration; B: second-degree laceration; C: mediolateral episiotomy; D: forceps delivery). Pelvic floor sEMG indices of the subjects were analyzed at 6–8 weeks postpartum. Results: The results showed that the mean peak amplitude of phasic (flick) contractions and the mean amplitude of tonic contractions were both significantly higher in CD than in VD (p < 0.01). In contrast, the mean amplitude variability of tonic contractions was lower in CD than in VD (p < 0.01). The mean peak amplitude of phasic (flick) contractions and the mean amplitude of tonic contractions were statistically lower in the forceps group than in the other vaginal delivery groups (p < 0.05). The mean amplitude variability of tonic contractions was greater in the forceps group than in groups A, B and C (p < 0.01). Conclusions: Vaginal delivery, especially forceps delivery, may result in impaired pelvic floor muscle function in the early postpartum period compared to cesarean delivery.

Keywords
pelvic floor dysfunction
pelvic floor muscle surface electromyography
postpartum
delivery mode
Glazer protocol
Funding
2019RU056/Chinese Academy of Medical Sciences Research Unit
2019-I2M-5-064/Shanghai Jiao Tong University, CAMS Innovation Fund for Medical Sciences (CIFMS)
GFY1808004/Shanghai Municipal Key Clinical Specialty
Figures
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