Takeaway
- Cesarean delivery (CD) reduces the risk of pelvic floor dysfunction compared with vaginal delivery (VD).
Why this matters
- Both damage to the pelvic floor during VD and increasing uterine volume during pregnancy itself, regardless of mode of delivery, are thought to affect pelvic floor function.
- When choosing mode of delivery, concern for pelvic floor dysfunction may be taken into consideration.
- Postpartum rehabilitation should be considered after CD.
Key results
- Pelvic floor muscle strength was higher in the CD group compared with the VD group (mean difference [MD], −11.94; P<.00001>
- Muscle voltage was higher in the VD group (MD, −9.45; P<.00001>
- Maximum urinary flow rate was higher in the VD group (MD, −5.67; P<.00001>
- Stress urinary incontinence was more common in the VD group (OR, 0.45; P<.00001>
- Pelvic organ prolapse was more common in the VD group (OR, 0.59; P<.00001>
Study design
- Systematic search and meta-analysis (n=9 studies included).
- Funding: None disclosed.
Limitations
- Limitations related to limitations of original studies.
- Protection of pelvic floor function may not be enough of a benefit to offer routine elective CD.
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