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Joint hypermobility, obstetrical outcomes, and pelvic floor disorders.

AbstractINTRODUCTION AND HYPOTHESIS:
Benign joint hypermobility syndrome may be a risk factor for pelvic floor disorders. It is unknown whether hypermobility impacts the progress of childbirth, a known risk factor for pelvic floor disorders. Our objective was to investigate the association between joint hypermobility syndrome, obstetrical outcomes, and pelvic floor disorders. Our hypotheses were: (1) women with joint hypermobility are less likely to experience operative delivery and prolonged second-stage labor; and (2) pelvic floor disorders are associated with benign hypermobility syndrome, controlling for obstetrical history.
METHODS:
Joint hypermobility was measured in 587 parous women (participants in a longitudinal cohort study of pelvic floor disorders after childbirth). Their obstetrical histories were obtained from review of hospital records. Pelvic floor disorders were assessed using validated questionnaires and a structured examination for prolapse. Joint hypermobility and pelvic floor disorders were evaluated at enrollment (5-10 years after first delivery). We compared obstetrical outcomes and pelvic floor disorders between women with and without joint hypermobility, defined as a Beighton score ≥ 4.
RESULTS:
Hypermobility was diagnosed in 46 women (7.8 %) and was associated with decreased odds of cesarean after complete cervical dilation or operative vaginal delivery [odds ratio (OR)=0.51; 95 % confidence interval (CI):0.27-0.95]. Anal sphincter laceration was unlikely to occur in women with hypermobility (OR=0.19; 95 % CI 0.04-0.80). However, hypermobility was not associated with any pelvic floor disorder considered.
CONCLUSIONS:
Benign joint hypermobility syndrome may facilitate spontaneous vaginal birth but does not appear to be a risk factor for pelvic floor disorders in the first decade after childbirth.
AuthorsLeise R Knoepp, Kelly C McDermott, Alvaro Muñoz, Joan L Blomquist, Victoria L Handa
JournalInternational urogynecology journal (Int Urogynecol J) Vol. 24 Issue 5 Pg. 735-40 (May 2013) ISSN: 1433-3023 [Electronic] England
PMID22898931 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Review)
Topics
  • Adult
  • Delivery, Obstetric (statistics & numerical data)
  • Female
  • Humans
  • Joint Instability (complications)
  • Labor, Obstetric (physiology)
  • Maryland (epidemiology)
  • Pelvic Floor Disorders (epidemiology, etiology)
  • Pregnancy

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