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Thoracic kyphosis and the Prevalence of Advanced Uterine Prolapse

Obstetrics & Gynecology: April 1996
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Objective To determine if there is an association between the degree of thoracic kyphosis and the prevalence of advanced uterine prolapse in women.

Methods A retrospective case-control study compared the degree of thoracic kyphosis among white women with advanced uterine prolapse with that of matched controls. Medical records were reviewed for 412 consecutive women who underwent either abdominal or vaginal hysterectomy. The cases were those with uterine prolapse to or beyond the level of the introitus, and women with no evidence of prolapse served as controls. Spinal curvature was measured properatively for each patient using a lateral chest x-ray and the Ferguson method. Forty-eight cases were matched to 48 controls for age, weight, menopausal status, and hormonal status. Results were stratified to analyze the effect of parity on the relationship between uterine prolapse and thoracic kyphosis.

Results The degree of thoracic kyphosis was higher in patients with uterine prolapse than in controls (mean paired difference = 4.9°,95% confidence interval [CI] 3.1–6.7; P < .001). Patients with uterine prolapse had a mean spinal curvature of 13.0° (95% CI 11.5–14.5), Whereas controls had on of 8.1° (95% CI 6.9–9.4). A higher degree of thoracic kyphosis was associated with an incremental higher occurrence of uterine prolapse (odds ratio 1.35,95% CI 1.11–1.65; P < .01).

Conclusion Thoracic kyphosis appears to be associated with uterine prolapse.

Address reprint requests to: Lawrence R. Lind, MD, Department of Obstetrics and Gynecology, Harbor/UCLA Medical Center, Box 489, 1000 West Carson Street, Torrance, CA 90509.

© 1996 The American College of Obstetricians and Gynecologists