Incontinence Risk Highest After Forceps Delivery.

Prospective study shows almost tripling of risk, compared with vaginal delivery.

LAKE BUENA VISTA, FLA.

-- Forceps delivery in primiparous women is significantly more likely than vacuum extraction or spontaneous vaginal delivery to result in persistent urinary incontinence.

That finding emerged from the first prospective study to assess the development of new-onset urinary incontinence around the time of delivery. The relative risk for persistent urinary incontinence was 2.8 at 1 year after forceps delivery and 0.8 after vacuum delivery, compared with the risk entailed with spontaneous vaginal delivery, Dr. Lily Arya reported at the annual meeting of the Society of Gynecologic Surgeons.

Although many retrospective studies have failed to show a relationship between forceps delivery and urinary incontinence, those studies were conducted many years after the patients had completed childbearing, when other factors such as changing estrogen levels at menopause, increased weight gain, and potential pelvic organ prolapse could have also contributed to urinary incontinence, said Dr. Arya of the division of urogynecology and reconstructive pelvic surgery at the University of Pennsylvania, Philadelphia.

In the current study, 150 women had undergone spontaneous vaginal delivery, 90 needed forceps assistance, and 75 had vacuum assistance.

At 2 weeks post partum, the prevalence of new-onset incontinence was 13.3% in the ...