IMR Press / CEOG / Volume 33 / Issue 4 / pii/2006056

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Effects of pregnancy and childbirth on the incidence of urinary disorders in multiple sclerosis

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1 Department of Physical Medicine and Rehabilitation, Centre Hospitalier Universitaire, Rennes-Cedex (France)
2 Multiple Sclerosis Clinic, Department of Neurology, Centre Hospitalier Universitaire, Rennes-Cedex (France)
3 Clinic of Physical Medicine and Rehabilitation Notre Dame de Lourdes, Rennes (France)
4 Deparment of Urology, Centre Hospitalier Universitaire, Rennes-Cedex (France)
Clin. Exp. Obstet. Gynecol. 2006, 33(4), 215–218;
Published: 10 December 2006
Abstract

Objective: Women with multiple sclerosis frequently pose questions to physicians regarding the potential negative impact of pregnancy, especially on urinary disorders. About 50 to 80% of patients suffer from urinary disorders during the course of the disease Trauma to the pelvic floor and the urethral sphincter during vaginal delivery may lead to the development of stress urinary incontinence. The purpose of this work was to study the consequences of pregnancy and childbirth on urinary problems. Study Design: An inception cohort of 368 consecutive women suffering from multiple sclerosis (MS), according to the Poser criteria, were included in the study between June 1999 and June 2000. For each patient a full urological and obstetrical record was obtained. Results: Two hundred and seventy-three women (74%) had had at least one pregnancy. The parous women were older at the time of the study (mean age: 45.5 years vs 35.5 years), and were older at MS onset (mean age: 32.8 years vs 25.7 years). The nulliparous women were more rapidly disabled, with a shorter time to reach an EDSS score of 3 from MS onset (mean time of 5.9 years versus 8.2 years in parous women). In parous women, 259 (95%) had had at least one vaginal delivery and 14 (5%) had had a caesarean only. Delivery modalities had no influence on urinary disorder frequency or the type of problems. Conclution: On the basis of_these data, there is actually no clear argement for systematically performing caesarean section in MS women. Urinary disorders in these women were mostly linked to the duration and the severity of the disease but not to pregnancy or delivery modalities. From our point of view, caesarean section must be decided only on classic obstetrical criteria as for healthy women independently of multiple sclerosis. However our data were open and retrospective.

Keywords
Multiple sclerosis
Urinary disorders
Pregnancy
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