TITLE:
Pelvic floor function and advanced maternal age at first vaginal delivery
AUTHORS:
Mikako Yoshida, Ryoko Murayama, Maki Nakata, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Hiromi Sanada
KEYWORDS:
Advanced Maternal Age; Pelvic Floor; Stress Urinary Incontinence; Ultrasound; Vaginal Delivery
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.4A,
June
18,
2013
ABSTRACT: Purpose: The
study aimed to show differences in temporal
recovery of pelvic floor function within 6 months postpartum between
women having their first delivery at an advanced age and those having their
first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5,
BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after
vaginal delivery. Urinary incontinence was assessed by the International
Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function
was assessed by the anteroposterior diameter of the levator hiatus using transperineal
ultrasound. Women who delivered for the first time at 35 years and/or older
were defined as being of advanced maternal age. Results: Nine of 17 women
(52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary
incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The
anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women
at 3 and 6 months postpartum (p p = 0.004). However, among the advanced
maternal age women, all parameters of the anteroposterior diameter of the levator
hiatus were not significantly different between the women with and without
stress urinary continence. Conclusion: Recovery of pelvic floor function following
delivery may be delayed in women of advanced maternal age at first delivery
because of the damage to the pelvic floor during pregnancy and vaginal delivery,
resulting in increase in the incidence of stress urinary incontinence.