Study of the relationship between mediolateral episiotomy in vaginal delivery and pelvic organ prolapse in pregnant mothers.

Abstract

Pelvic Floor Disorders (PFDs) are a group of disorders of the female reproductive system that can cause a variety of problems for women. PFDs can include Urinary Incontinence (UI) and Pelvic Organ Prolapse (POP). This study evaluated the association between mediolateral episiotomy during pregnancy and POP in patients. A cross-sectional study with prospective follow-up was conducted on 150 pregnant women admitted for vaginal delivery at Furqani Hospital in Qom, Iran. Participants were divided into episiotomy and non-episiotomy groups based on clinical indications. Pelvic organ prolapse was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and 3-6 months postpartum. Data were analyzed using SPSS version 26, with a significance level of 0.05. The study included 142 patients with a mean age of 29.67 years. No significant differences were observed in demographic or clinical variables between the episiotomy and non-episiotomy groups at baseline. Postpartum, the episiotomy group showed significant improvements in cystocele severity (P=0.038), rectocele severity (P=0.026), apical prolapse (P=0.011), levator tone (P=0.016), and perineal descent (P=0.016). However, the cough test results did not differ significantly (P=0.052). Mediolateral episiotomy during vaginal delivery was associated with reduced severity of POP and improved PFD. These findings suggest a potential protective effect of episiotomy against certain pelvic floor complications, although further studies with larger sample sizes and longer follow-up periods are needed to confirm these results.