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Evaluation of Pelvic Floor Symptoms and Sexual Function in Primiparous Women Who Underwent Operative Vaginal Delivery Versus Cesarean Delivery for Second-Stage Arrest

Crane, Andrea K. MD*; Geller, Elizabeth J. MD*; Bane, Heather MD; Ju, Rujin MD*; Myers, Erinn MD*; Matthews, Catherine A. MD*

Female Pelvic Medicine & Reconstructive Surgery: January/February 2013 - Volume 19 - Issue 1 - p 13–16
doi: 10.1097/SPV.0b013e31827bfd7b
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Objectives: This study aimed to compare the prevalence and severity of pelvic floor symptoms and sexual function at 1 year postpartum in women who underwent either operative vaginal delivery (OVD) or cesarean delivery (CD) for second-stage arrest.

Methods: In this cohort study, women with second-stage arrest in their first pregnancy who delivered between January 2009 and May 2011 at 2 different institutions were identified by an obstetric database using International Classification of Diseases, Ninth Revision, codes. Validated questionnaires evaluating pelvic floor symptoms and sexual function were administered. Subjects were dichotomized into those who underwent an OVD or a CD. Additional analyses by intent-to-treat and stratification of vacuum versus forceps operative deliveries were performed.

Results: Of the 109 women who completed the 1-year postpartum symptom questionnaires, 53 (48.6%) had a successful OVD, 20 (18.3%) failed OVD and underwent CD, and 36 (33%) underwent CD only. There were no differences between those who had a successful OVD and those who underwent a CD in either pelvic floor function or sexual function, but bulge symptoms were more common in the OVD group (7.5% vs 0, P = 0.05). When analyzed by intent-to-treat (planned OVD vs planned CD), pelvic floor symptoms remained similar between groups. However, those in the planned CD group reported higher orgasm and overall sexual satisfaction scores.

Conclusions: In this sample of primiparous women with second-stage arrest, mode of delivery did not significantly impact pelvic floor function 1 year after delivery, except for bulge symptoms in the OVD group and sexual satisfaction in the planned CD group.

Mode of delivery does not significantly impact pelvic floor function at one year, except for bulge symptoms in those that had an operative vaginal delivery.

From the *Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; and †Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, NC.

Reprints: Andrea K. Crane, MD, 3032 Old Clinic Bldg, Campus Box 7570, Chapel Hill, NC 27599. E-mail: acrane@med.unc.edu.

The authors have declared that they have no relevant conflicts of interest.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins