Postpartum Pelvic floor disorder in Primiparous women - A prospective observational study

Abstract

ABSTRACT Purpose: Pelvic floor dysfunction (PFD) describes clinical conditions related to changes in the pelvic floor causing voiding and defecation problems, pelvic organ prolapse (POP), sexual dysfunction, and pelvic pain. The postpartum period being associated with the onset or aggravation of PFD gives us an opportunity for identification and intervention. The evidence implicating vaginal delivery as a cause of PFD is controversial. This study will increase the understanding of the effect of vaginal birth on PFD, especially in the South Asian population. Methodology: A prospective observational study using pelvic floor disability index (PFDI 20) questionnaire (Hindi Version) was conducted. Two hundred primiparous women with term singleton fetuses who were admitted for planned delivery at term were enrolled and PFDI 20 questionnaire was filled. These women were followed till delivery and divided into two groups normal vaginal delivery (NVD) and LSCS. Enrolled women were followed up at 3 months postpartum and assessed using the PFDI 20 questionnaire. Results: Most common PFD symptom was POP in both groups followed by fecal incontinence and urinary incontinence symptoms. The percentage prevalence of any PFD symptoms was more in LSCS 67% as compared to 63% in the NVD group. The women with body mass index >28, prolonged labor >18 h, and instrumental delivery women with birth weight >3 kg had a higher prevalence of any PFD symptoms at 3 months postpartum irrespective of mode of delivery. Conclusion: Vaginal delivery should always remain as the first and best choice for delivery.