Pelvic pain and urinary symptoms can present following delivery, but how does delivery method impact these symptoms? Dr Daniel G. Kiefer, physician in the division of maternal-fetal medicine/obstetrics in Lehigh Valley Health Network in Allentown, Pennsylvania, and colleagues conducted a prospective observational cohort study to further explore this question.
Pelvic pain and urinary symptoms can present following delivery, but how does delivery method impact these symptoms? Dr Daniel G. Kiefer, physician in the division of maternal-fetal medicine/obstetrics in Lehigh Valley Health Network in Allentown, Pennsylvania, and colleagues conducted a prospective observational cohort study to further explore this question. They presented their findings at the 59th Annual Clinical Meeting of the American Congress of Obstetricians and Gynecologists in Washington, DC.
Kiefer and colleagues followed 169 hospitalized postpartum patients. Slightly more women had vaginal deliveries (n = 101) than cesarean deliveries (n = 68). On enrollment, the researchers ascertained demographic data, medical history, perinatal factors, and social support information.
The Pelvic Pain and Urinary Urgency/Frequency Symptom Scale (PUF Questionnaire) was employed to ascertain and assess pelvic pain and urinary symptoms at a 6-month and 12-month follow-up. This self-report questionnaire uses a symptom score (which measures how often a patient experiences problems) as well as a bother score (which notes the degree to which the symptoms bother the patient); the bother and symptom score combine for a total PUF score. Scores range between 0 and 35, and studies have indicated that a score greater than 12 is indicative of significant symptoms.
The researchers found similar results in median PUF scores among women who had a vaginal delivery as compared to those who had a cesarean delivery. At 6 months, the median PUF score was 4 (range = 0 to 10) for women who experienced a vaginal delivery, while women who experienced a caesarian delivery had a median PUF score of 3 (range = 1 to 8). Similar results were found at the 12-month follow-up. The researchers failed to find any differences in the symptom or bother scores.
The results of this prospective study further support the relative safety of cesarean deliveries, since over time there was minimal difference in pelvic pain and urinary symptoms among the patients. The researchers concluded, “There does not appear to be a difference in pelvic pain or urinary symptoms when comparing vaginal versus cesarean deliveries through the first year after childbirth.”
Pelvic Pain and Urinary Urgency/Frequency Symptom Scale
Pelvic Floor Disorders
Short IPGH System for Assessment of Pelvic Floor DiseasePelvic Floor Muscle Training and Adjunctive Therapies for the Treatment of Stress Urinary Incontinence in Women
Kiefer DG, Moon FR, Lee L. Impact of route of delivery on pelvic pain and urinary symptoms. ACOG Annual Meeting. Poster 83. April 30, 2011.