Postpartum pelvic organ prolapse in women with cesarean section at different time during delivery

Objective To study and analyze the incidence of pelvic organ prolapse (POP) in women who underwent cesarean section. Methods A cross-sectional study was conducted. The clinical data of the women who underwent regular antepartum examination and cesarean delivery in Peking University People′s Hospital from January 2019 to June 2019 were collected, including the cervical dilatation. The incidence of POP was analyzed. Results (1) A total of 345 women met the inclusion criteria, with cervical dilatation of 0-10 cm before cesarean section, the cervix was not dilatated in 58.6% (202/345) of the women, and the cervix was fully dilatated in 2.9% (10/345) of the women. There were 109 cases of POP stage Ⅰ or above, 13 cases of POP stage Ⅱ, and no stage Ⅲ or Ⅳ. The incidence of POP was 31.6% (109/345). (2) Statistical analysis showed that the cervical dilatation of the POP group was significantly larger than that of the non-prolapse group (median: 1.0 vs 0 cm;Z=-2.227, P=0.026). The risk of POP of vaginal trial-birth transfer to cesarean section was higher than that of elective cesarean section [42.4% (36/85) vs 28.1% (73/260), P=0.014]. However, the further analysis of Spearman correlation between cervical dilatation, elective cesarean section and POP, as well as the receiver operating characteristic curve showed that the correlation and prediction value were poor. Conclusion Elective cesarean section has a certain protective effect on postpartum prolapse, but the protective effect of vaginal trial-birth transfer to cesarean section on pelvic floor is weakened. Key words: Pelvic organ prolapse; Cesarean section; Parturition; Time