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. 2024 Mar 7;24(1):178.
doi: 10.1186/s12884-024-06366-6.

Association of the second birth mode of delivery and interval with maternal pelvic floor changes: a prospective cohort study

Xiaoli Wu  1 , Xiu Zheng  2 , Xiaohong Yi  2 , Bolin Fan  2
Affiliations

Association of the second birth mode of delivery and interval with maternal pelvic floor changes: a prospective cohort study

Xiaoli Wu et al. BMC Pregnancy Childbirth. .

Abstract

Background: This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes.

Methods: This prospective cohort study included women who had a first delivery and were in weeks 36-41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver.

Results: There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P < 0.001). The women with Cesarean section had a smaller hiatus area and circumference (P < 0.001 and P < 0.001). The hiatus diameters decreased with time in both groups (all P < 0.001) and were smaller after Cesarean section (both P < 0.001). The bladder neck at maximum Valsalva increased with time (all P < 0.001) without significant differences between the two groups. Finally, the proportion of patients with POP-Q stage 0/I increased with time in both groups (all P < 0.001), with the proportions being higher in the Cesarean group (P = 0.002). The birth interval was negatively correlated with the hiatus area (B=-0.17, 95%CI: -0.25, -0.08, P < 0.001) and positively correlated with the bladder neck at rest (B = 0.22, 95%CI: 0.08, 0.35, P = 0.001) and at maximum Valsalva (B = 0.85, 95%CI: 0.65, 1.05, P < 0.001).

Conclusions: In conclusion, the mode of delivery at the second birth could influence the hiatus area and circumference and bladder neck size. The birth interval was negatively correlated with the hiatus area and positively correlated with the bladder neck at rest and at maximum Valsalva.

Keywords: Birth intervals; Delivery, obstetrics; Pelvic floor; Pelvic floor disorders.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Two-dimensional ultrasound image. (Left) At rest; (Right) At maximum Valsalva. 1 : reference line; 2 : posterior angle of the bladder and urethra; 3 : distance between the cervix and the reference line; 4 : distance between the external cervix and the reference line; 5 : distance between the ampulla of the rectum and the reference line; 6 : reference line; 7 : posterior angle of the bladder and urethra
Fig. 2
Fig. 2
Four-dimensional hiatus sonography (1 A: basin septal hole area; 1 C: basin septal hole circumference; 2: basin septal hole diameter; 3: anterior and posterior diameters of basin septa). (A) Resting state. (B) Retracted anus state. (C) Maximum Valsalva state
See this image and copyright information in PMC

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