Single vaginal delivery ups later risk of pelvic organ prolapse

Maria Gyhagen, from the Sahlgrenska Academy at Gothenburg University in Sweden, and colleagues examined the prevalence and risk factors for sPOP and concomitant urinary incontinence 20 years after one cesarean section or vaginal delivery. A total of 5,236 singleton primiparae with a birth in 1985 to 1988 with no further births were surveyed using validated questionnaires.

The researchers found that there was an increased prevalence of sPOP after vaginal delivery compared with cesarean section (14.6 versus 6.3 percent; odds ratio, 2.55). No increase was seen after acute versus elective cesarean section. Compared with spontaneous vaginal delivery there was no increased risk of sPOP with episiotomy, vacuum extraction, and second-degree or more laceration. With each unit increase of current body mass index and each 100 g increase in birth weight, there was a significant 3 percent increase in sPOP. The prevalence of sPOP was doubled for mothers ≤160 cm in height who delivered a child weighing 4,000 g or greater, compared with short mothers who delivered an infant weighing less than 4,000 g (24.2 versus 13.4 percent; odds ratio, 2.06). Compared with women without prolapse, women with sPOP more often had urinary incontinence and urinary incontinence for more than 10 years.

"The prevalence of sPOP was doubled after vaginal delivery compared with caesarean section, two decades after one birth," the authors write.

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Journal reference: BJOG: An International Journal of Obstetrics and Gynaecology

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