 | | | | Related Healthscout Videos | |
|
By Lucy Williams, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire) -- One in nine women will need surgery at some point to correct pelvic prolapse -- a condition researchers are linking to childbirth. Muscle damage caused during vaginal delivery may lead to fallen bladder and bowel displacement, according to the results of a new study.
Text Continues Below
Pelvic prolapse indicates the falling of the bladder, uterus or lower bowel. Urinary incontinence can result from pelvic prolapse. Recent research at the University of Michigan Health System in Ann Arbor is giving doctors a better idea why prolapse occurs.
"We're starting to get an idea about what the causes are so we can develop strategies to be able to prevent it in the future," John DeLancey, M.D., professor of obstetrics and gynecology and director of pelvic floor research at the University of Michigan Medical School, told Ivanhoe.
Researchers studied muscle damage in 151 women with a history of pelvic prolapse and 135 women with no history of prolapse. They used magnetic resonance imaging (MRI) to assess damage to the levator ani muscles -- muscles supporting the bowels. Women with prolapse had nearly four-times more muscle damage than women who did not experience prolapse.
Of the women with a history of prolapse, 52 percent said their caregiver used forceps during delivery. Of women with no history of prolapse, 27 percent said their caregiver used forceps during delivery.
Dr. DeLancey said the use of forceps appears to put a patient at risk for permanent muscle damage, and researchers should look into safer options. But sometimes there is no better alternative.
"If the baby is in distress and the obstetrician can get it out more quickly with forceps, then I'm sure any mother would say, 'If it's going to cause me a problem that's not going to be a problem until I'm 50 or 60, then it's important to my baby's health,'" he said.
A family history of pelvic prolapse also appears to put women at risk. Of women who experienced prolapse, 31 percent reported a family history of the condition. Only 13 percent of women who did not experience prolapse reported a family history of the condition. Dr. DeLancey said many women did not know if they had a family history of prolapse because it's a topic not all families discuss.
Although research indicates vaginal delivery can cause irreversible muscle damage that leads to pelvic prolapse, researchers do not endorse more elective C-sections.
"There's been a rash of recent articles about elective caesarean section to prevent injuries that lead to fallen uteruses and bladders," Dr. DeLancey said. "The number of women injured is actually quite small and the problems don't happen until later in life, but now that we've got information about a specific link at birth, I think we can probably come up with some preventive strategies."
Further research is needed to determine the safest delivery procedures and techniques.
"We've been trying to moderate and reassure people that vaginal delivery is safe," Dr. DeLancey said. "If forceps really does turn out to be the thing that causes most of the damage and it's the choice between forceps and a vacuum, or a forceps and a C-section, we should have those conversations with women so the least damaging delivery can be done."
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
SOURCE: Ivanhoe interview with John DeLancey, M.D.; Obstetrics & Gynecology, 2007;109
|
.gif)
