Birth trauma: short and long term effects of forceps delivery compared with spontaneous delivery on various pelvic floor parameters
Article first published online: 12 AUG 2005
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 107, Issue 11, pages 1360–1365, November 2000
How to Cite
Meyer, S., Hohlfeld, P., Achtari, C., Russolo, A. and De Grandi, P. (2000), Birth trauma: short and long term effects of forceps delivery compared with spontaneous delivery on various pelvic floor parameters. BJOG: An International Journal of Obstetrics & Gynaecology, 107: 1360–1365. doi: 10.1111/j.1471-0528.2000.tb11648.x
- Issue published online: 12 AUG 2005
- Article first published online: 12 AUG 2005
- Accepted 26 July 2000
Objective To compare the effects of forceps delivery and spontaneous delivery on pelvic floor functions in nulliparous women.
Design A longitudinal prospective study with investigations during the first pregnancy, 10 weeks and 10 months after delivery.
Setting Antenatal clinic in a teaching hospital.
Population One hundred and seven patients aged 28.4 years, divided into those with forceps (n= 25) or spontaneous (n= 82) delivery.
Methods Investigations with a questionnaire, clinical examination, assessment of bladder neck behaviour, urethral sphincter function, intra-vaginal/intra-anal pressures during pelvic floor contractions.
Results The incidence of stress urinary incontinence was similar in both groups at 9 weeks (32%vs 21%, P= 0.3) and 10 months (20%vs 15%, P= 0.6) after delivery, as was the incidence of faecal incontinence (9 weeks: 8%vs 4%, P= 0.9; 10 months: 4%vs 5%, P= 1) and the decreased sexual response at 10 months (12%vs 18%, P= 0.6). Bladder neck behaviour, urethral sphincter function and intra-vaginal and intra-anal pressures were also similar in the two groups. However, 10 months after delivery, the incidence of a weak pelvic floor (20%vs 6%, P= 0.05) and the decrease in intra-anal pressure between the pre- and post-delivery values (−17±28 cm H2O vs 3±31 cm H2O, P= 0.04) were significantly greater in the forceps-delivered women.
Conclusions Forceps delivery is not responsible for a higher incidence of pelvic floor complaints or greater changes in bladder neck behaviour or urethral sphincter functions. However, patients with forceps delivery have a significantly greater decrease in intra-anal pressure and a greater incidence of a weak pelvic floor.