Retrospective evaluation of the impact of second-stage labor arrest on stress urine incontinence in postpartum women
Author(s): Georges Yared, Jihad Al Hassan, Charlotte Hajjar, Kariman Ghazal
Background: Stress Urinary Incontinence (SUI), has been always linked to normal vaginal delivery (NVD) or operative vaginal delivery (OVD). Many women get concerned about this issue before giving birth and tend to deliver by cesarean delivery. However, the increased frequency of cesarean deliveries poses health concerns especially in the absence of solid risk factors.
Methods: This is a retrospective observational cohort study conducted at Rafic Hariri University Hospital (RHUH) between 2011 and 2013. Forty primiparous women undergoing cesarean delivery were involved. They were evenly divided into 2 groups. The first involved those who underwent elective cesarean delivery and those with failure to progress. The second group involved women who underwent cesarean delivery for arrested second stage of labor. Statistical analysis was performed using the statistical program SPSS version 20.
Results: The prevalence of SUI in group 1 was 25% compared to 35% in group 2. Cesarean delivery was not found to have any protective role against SUI in group 1 patients and the frequency of SUI in selective cesarean patients was nearly the same as those performing cesarean for failure to progress. However, patients undergoing cesarean for arrested second stage of labor > 2hours had a significant higher frequency of SUI as compared to patients undergoing cesarean delivery for arrested second stage of labor < 2hours.
Conclusion: Cesarean delivery cannot be proposed to women who fear to suffer from SUI post-partum. However, it should be done if the cervix fully dilated for > 2hours in order to decrease the risk of SUI.