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Vaginal delivery spontaneous or assisted is the single risk factor most likely to cause maternal pelvic floor trauma.
Pelvic floor injury delivery. Primiparity instrumental delivery large fetal head circumference and prolonged second stage of delivery are risk factors for pfd. Demographics labor and delivery variables. These injuries can be picked up if a check is done after six weeks via a vaginal examination. The first delivery tends to be associated with the greatest amount of damage.
Once injury to the pelvic floor has occurred the muscles and connective tissue no longer provide the support they once did. Less frequently childbirth can cause injury to the pelvic floor that is so severe that it may affect the muscles around the back passage or anus. These issues are closely associated. Intact neuromuscular function and pelvic support are crucial to pelvic stability.
Understanding the mechanism of injury to the muscle of the levator ani is imperative to minimizing injury with delivery. 3 there are no symptoms and no damage is seen but there is a pelvic floor muscle injury. Pelvic floor injury after childbirth unfortunately it is difficult to know which women will have trauma and those that won t. Similarly 20 to 25 is a general threshold for decision making.
Labor and delivery variables were obtained by hospital chart review conducted by a certified nurse midwife. However some women can identify the specific pregnancy or delivery that seemed to have the greatest adverse impact on their pelvic floor function. If the pelvic floor muscles are damaged or torn from the bone during the delivery the damage is not seen from the outside so is therefore not diagnosed at the time. While exact causes are still being researched doctors can link pelvic floor dysfunction to conditions or events that weaken the pelvic muscles or tear connective tissue.
Based on our findings we have suggested a flowchart helping the obstetrician to conduct vaginal delivery with minimal pelvic floor insult. This paper focused on injury of the pubic symphysis and not an analysis of levator ani injury. Pregnancy and delivery contribute to pelvic floor disorders due to compression stretching or tear of nerve muscle and connective tissue. We describe below the main mechanisms of obstetrical injury.
This muscle complex called the anal sphincter is responsible for preventing loss of stool faeces or wind flatus from the back passage.
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