FRIDAY, Feb. 2 (HealthDay News) -- Women who have had a forceps delivery are more than three times as likely to have major levator ani defects leading to pelvic organ prolapse than women who have not had forceps delivery, researchers report in a study published in the February issue of Obstetrics & Gynecology.
John DeLancey, M.D., of the University of Michigan in Ann Arbor, and colleagues evaluated levator ani structure and function in a matched, case-control study of 286 women, mean age 56 years, including 151 who had pelvic organ prolapse and 135 controls.
Major levator ani defects were seen in 55 percent of cases and 16 percent of controls. Women with prolapse had a similar rate of minor defects (16 percent) as controls (22 percent). Fifty-three percent of women who reported delivery by forceps had major defects compared with 28 percent for those without forceps delivery.
"The association of levator ani injury prolapse is a plausible factor in the pathophysiology of prolapse but does not account for all pelvic organ prolapse," the authors conclude. "The fact that 30 percent of the women with prolapse had no evidence of a muscle defect on MRI supports the fact that the disease process involves other factors as well."
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