Lower urinar tract syptoms and obstetric parameters / Sintomas do trato urinario inferior e antecendentes obstetricos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Objective: The purpose of this study was to investigate lower urinary tract symptoms (LUTS) three years after delivery in women previously evaluated in the third trimester of pregnancy and its correlation to obstetric parameters and to social problems. Methods: A prospective study was undertaken. In a previous study, 340 pregnant women attending the Antenatal Clinic at The State University of Campinas (Unicamp) were interviewed and responded a structure pre-tested questionnaire about LUTS and obstetric parameters. After delivery, 120 women out of 340 were contacted by telephone and interviewed by a second questionnaire about obstetric parameters, LUTS and its correlation to social problems. LUTS were classified as stress urinary incontinence (SUI) and irritative bladder symptoms. The correlation between LUTS and mode of delivery (exclusively vaginal or c-section), parity, maternal age, birth weight, episiotomy and forceps was analyzed. Associations between LUTS and obstetric parameters were assessed by Fisher?s exact test and X2. The comparison of LUTS frequency during pregnancy and after delivery was analyzed by McNemar test (p<0.05). Results: The study group consisted of 37.5% primiparous and 62.5% multiparous women. The prevalence of SUI (57.5%) and nocturia (80.0%) was higher during pregnancy than its incidence postpartum, 13.7% and 16.7%, respectively and statistic significance has been observed. The incidence of urgeincontinence was higher postpartum (30.5%) than its prevalence during pregnancy (20.8%) with statistic significance. No statistical difference was found between irritative bladder symptoms and mode of delivery or parity. The incidence of SUI after delivery dropped significantly from 51.1% to 24.4% in the primiparous and from 60.0% to 28.3% in the multiparous 2-3, but not in the multiparous with four or more deliveries (66.7% to 60.0%). A significant correlation has been observed between SUI and parity. No statistic correlation was observed between SUI and mode of delivery. No significant correlation was observed between SUI or irritative bladder symptoms and maternal age, birth weight, episiotomy and forceps. We observed that only 35.6% women with irritative bladder symptoms exclusively mentioned social embarrassment, while 91.4% with stress urinary incontinence associated referred embarrassment. Conclusion: This study suggested that pregnancy is significantly associated with the occurrence of stress urinary incontinence and nocturia. Urge-incontinence was more frequent postpartum. After childbirth, irritative bladder symptoms were not associated to mode of delivery, parity, maternal age, birth weight, episiotomy and forceps. No correlation has been observed between mode of delivery and SUI, but parity predisposes to SUI three years after delivery. Most women considered that SUI can cause social embarrassment

ASSUNTO(S)

periodo pos-parto cesarea postpartum period parto (obstetricia) urinary incontinence episiotomy social problems incontinencia urinaria cesarean section episiotomia problemas sociais

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