Abstract | INTRODUCTION 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.
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Authors | Leise R Knoepp, Kelly C McDermott, Alvaro Muñoz, Joan L Blomquist, Victoria L Handa |
Journal | International urogynecology journal
(Int Urogynecol J)
Vol. 24
Issue 5
Pg. 735-40
(May 2013)
ISSN: 1433-3023 [Electronic] England |
PMID | 22898931
(Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Review)
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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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