C-section for obstructed labor linked to incontinence. (Lower Risk with Elective C-Section).

SAN FRANCISCO -- Women who had an elective cesarean section with no trial of labor were less likely to develop postpartum urinary incontinence than were women who delivered either vaginally or by C-section after an obstructed trial of labor in a study of 318 patients.

Results of the prospective study were reported by Dr. Eli Rimon at the annual meeting of the Society for Maternal-Fetal Medicine.

The incontinence rate of the group that delivered vaginally did not differ significantly from the group that underwent C-section after labor became obstructed, however. (See table.) It may be that pelvic floor injury after a trial of labor is already too extensive to be mitigated by a C-section. The findings raise the controversial question of whether prevention of pelvic floor injury should be an indication for elective C-section, Dr. Rimon of Tel Aviv University said in a poster presentation at the meeting.

Interviews with patients 1 year after delivery of their first child found persistent symptoms of stress urinary incontinence in 12% of women who had a spontaneous vaginal delivery, 13% of those who underwent C-section for obstructed labor, and 5% of those who had an elective C-section without labor.

Among women who underwent C-section for obstructed labor, persistent postpartum incontinence was more likely to occur in those who had stress urinary incontinence during ...