Pregnancy, labour and delivery as risk factors for pelvic organ prolapse: a systematic review.
Childbirth
Delivery
Labour
Levator avulsion
POP
Pelvic organ prolapse
Pregnancy
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
04
11
2020
accepted:
04
02
2021
pubmed:
12
3
2021
medline:
14
8
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
Pregnancy and childbirth are considered risk factors for pelvic organ prolapse (POP). The long latency between obstetric events and morbidity hinders the establishment of cause-effect relationships. Recently, intermediate outcomes such as organ descent and levator avulsion (LA) have been identified. We aimed to assess the effect of obstetric events on symptoms and signs of POP and on LA. We systematically reviewed the literature by searching PubMed/MEDLINE, Embase and Cochrane Library. We included studies in women examining associations between obstetric events and symptoms and signs of POP and LA, assessed through questionnaires, clinical examination and pelvic floor imaging. Two reviewers evaluated the studies for eligibility and for methodological quality/susceptibility to bias. We extracted study results and clustered them by outcome: symptoms of POP (sPOP), clinical findings of POP (cPOP) and LA. When appropriate, we performed a random-effect meta-analysis and reported the summary odds ratios (OR) with 95% confidence intervals. Heterogeneity across studies was assessed using the I The first vaginal delivery was a risk factor for POP as measured by sPOP (OR: 2.65 [1.81-3.88]), cPOP (OR: 4.85 [2.15-10.94]) and in association with LA (OR: 41.6 [4.13- 419.41]). Forceps delivery was a risk factor for POP as measured by sPOP (OR: 2.51 [1.34-4.69]), cPOP (OR: 1.68 [1.21-2.34]) and in association with LA (OR: 5.92 [3.75-9.34]). Birth exclusively by caesarean was protective for sPOP (OR: 0.38 [0.29-0.51]) and for cPOP (OR: 0.29 [0.20-0.41]) and it did not confer any additional risk compared to nulliparity. This review confirms a strong aetiological link between vaginal birth and POP, with the first vaginal and forceps delivery being the main determinants.
Identifiants
pubmed: 33704536
doi: 10.1007/s00192-021-04724-y
pii: 10.1007/s00192-021-04724-y
doi:
Substances chimiques
Nuclear Proteins
0
Repressor Proteins
0
SPOP protein, human
0
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1623-1631Informations de copyright
© 2021. The International Urogynecological Association.
Références
Dickinson R. Studies of the levator ani muscle. The American Journal of Obstetrics and Diseases of Women and Children. 1889;22(9):897–917.
Halban J, Tandler J. Anatomie und Aetiologie der Genitalprolapse beim Weibe. Vienna: Braumueller; 1907. 273 p
Thomas V, Shek K, Guzman Rojas R, Dietz H. The latency between pelvic floor trauma and presentation for prolapse surgery. Ultrasound Obstet Gynecol. 2013;42(S1):39.
doi: 10.1002/uog.12692
Thomas V, Shek KL, Guzman Rojas R, Dietz HP. Temporal latency between pelvic floor trauma and presentation for prolapse surgery: a retrospective observational study. Int Urogynecol J. 2015;26(8):1185–9.
doi: 10.1007/s00192-015-2677-x
Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, et al. Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system [see comments]. Am J Obstet Gynecol. 1996;175(6):1467–70 discussion 70-.
doi: 10.1016/S0002-9378(96)70091-1
Singh K, Reid WM, Berger LA. Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obst Gynecol. 2001;185(1):71–7.
doi: 10.1067/mob.2001.113876
Dietz H. Ultrasound in the assessment of pelvic organ prolapse. Best Pract Res OB/GYN. 2019;54:12–30.
doi: 10.1016/j.bpobgyn.2018.06.006
Dietz HP, Steensma AB. The prevalence of major abnormalities of the levator ani in urogynaecological patients. BJOG Int J Obstet Gynaecol. 2006;113(2):225–30.
doi: 10.1111/j.1471-0528.2006.00819.x
DeLancey J, Morgan D, Fenner D, Kearney R, Guire K, Miller J, et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstet Gynecol. 2007;109(2):295–302.
doi: 10.1097/01.AOG.0000250901.57095.ba
Dietz H, Simpson J. Levator trauma is associated with pelvic organ prolapse. Br J Obstet Gynaecol. 2008;115:979–84.
doi: 10.1111/j.1471-0528.2008.01751.x
AIUM/IUGA practice parameter for the performance of Urogynecological ultrasound examinations : developed in collaboration with the ACR, the AUGS, the AUA, and the SRU. Int Urogynecol J. 2019;30(9):1389–400.
Dietz H, Shek K. Repeatability of digital palpation for the detection of levator trauma. Int Urogynecol J. 2007;18(S1):S156.
Weber AM, Buchsbaum GM, Chen B, Clark AL, Damaser MS, Daneshgari F, et al. Basic science and translational research in female pelvic floor disorders: proceedings of an NIH-sponsored meeting. Neurourol Urodyn. 2004;23(4):288–301.
doi: 10.1002/nau.20048
Leng B, Zhou Y, Du S, Liu F, Zhao L, Sun G, et al. Association between delivery mode and pelvic organ prolapse: a meta-analysis of observational studies. Eur J Obstet Gynecol Reprod Biol. 2019;235:19–25.
doi: 10.1016/j.ejogrb.2019.01.031
Friedman T, Eslick GD, Dietz HP. Delivery mode and the risk of levator muscle avulsion: a meta-analysis. Int Urogynecol J. 2019;30(6):901–7.
doi: 10.1007/s00192-018-3827-8
de Araujo CC, Coelho SA, Stahlschmidt P, Juliato CRT. Does vaginal delivery cause more damage to the pelvic floor than cesarean section as determined by 3D ultrasound evaluation? A systematic review. Int Urogynecol J. 2018;29(5):639–45.
doi: 10.1007/s00192-018-3609-3
Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777–84.
doi: 10.7326/M14-2385
Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14:579. https://doi.org/10.1186/s12913-014-0579-0 .
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
doi: 10.1002/nau.20798
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool forassessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://doi.org/10.1136/bmj.i4919 .
Vandenbroucke JP, Von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Ann Intern Med. 2007;147(8):W163–W94.
doi: 10.7326/0003-4819-147-8-200710160-00010-w1
Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL, et al. Long-term impact of mode of delivery on stress urinary incontinence and urgency urinary incontinence: a systematic review and meta-analysis. Eur Urol. 2016;70(1):148–58.
doi: 10.1016/j.eururo.2016.01.037
Gyhagen M, Bullarbo M, Nielsen T, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. Br J Obstet Gynaecol. 2013;120:152–60.
doi: 10.1111/1471-0528.12020
Glazener C, MacArthur C, Bain C, Dean N, Toozs-Hobson P, Richardson K, et al. Epidemiology of pelvic organ prolapse in relation to delivery mode history at 12 years after childbirth: a longitudinal cohort study. Neurourol Urodyn. 2010;29(6):819–20.
Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Munoz A. Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstet Gynecol. 2011;118(4):777–84.
doi: 10.1097/AOG.0b013e3182267f2f
Dietz HP, Beer-Gabel M. Ultrasound in the investigation of posterior compartment vaginal prolapse and obstructed defecation. Ultrasound Obstet Gynecol. 2012;40:14–27.
doi: 10.1002/uog.10131
Dietz HP, Shek C. The urethral motion profile: a new method for assessing urethral mobility. Ultrasound Obstet Gynecol. 2007;30(4):448–9.
doi: 10.1002/uog.4371
Cheung RY, Shek KL, Chan SS, Chung TK, Dietz HP. Pelvic floor muscle biometry and pelvic organ mobility in East Asian and Caucasian nulliparae. Ultrasound Obstet Gynecol. 2015;45(5):599–604.
doi: 10.1002/uog.14656