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Epidural analgesia can raise the
risk of postpartum dyspareunia and elicit longer durations of labor, that
warrants rehabilitation attention following delivery.
A recent study found that at six months postpartum in primiparous females who delivered vaginally, epidural analgesia is linked with an elevated risk of dyspareunia, and women using epidural analgesia had longer first, second, and total labor stage durations. This prospective observational cohort study was carried for determining epidural analgesia's impact on pelvic floor dysfunction (PFD) in 150 females in preparation for vaginal delivery, with 74 (49.3%) being given epidural analgesia.
Collection of baseline demographic and intrapartum data was done. At six months postpartum, the PFD symptoms, including overactive bladder, stress urinary incontinence, pelvic organ prolapse, defecation impairment, and four kinds of sexual dysfunction (dyspareunia, arousal disorder, orgasm disorder, and low sexual desire), were assessed. Determination of postpartum depression and pelvic floor muscle (PFM) functioning was also done. For identifying factors linked with PFD symptoms impacted by epidural analgesia, multivariate logistic regression was applied.
With the help of the female sexual function index (FSFI-12) and pelvic floor distress inventory-20 (PFDI-20), the determination of sexual dysfunctioning and PFD symptoms was done. Using palpation and surface electromyography (sEMG), an examination of PFM function was done. Assessment of postpartum depression was carried out via Self-Rating Depression Scale (SDS).
At six months postpartum, females who received epidural analgesia had a greater occurrence of dyspareunia (43.2% vs 26.3%) and longer 1st, 2nd, and total stage of labor durations compared to females without epidural analgesia, as shown in Table 1:
No profound differences were noted
between the two groups in terms of other PFD symptoms or PFM function. The
multivariate logistic regression demonstrated that for dyspareunia, epidural
analgesia (OR = 3.056) and SDS scores (OR = 1.066) were independent risk
factors. Additional research with larger sample size is required for
determining the effect of epidural analgesia on other symptoms of PFD, concluded the study authors.
Sexual Medicine
Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study
Jingran Du et al.
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