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Painless labor with patient-controlled epidural analgesia protects against short-term pelvic floor dysfunction: a retrospective cohort study.

BACKGROUND
The aim of the present study was to investigate whether painless labor with patientcontrolled epidural analgesia (PCEA) has a protective effect on pelvic floor function. And to observe if there was any difference in the effect of painless labor with PCEA versus vaginal delivery on postpartum shortterm pelvic floor function.


METHODS
All women who delivered at the hospital's obstetric department during June 2016 to October 2018 were included in the study. They were divided according to delivery mode: painless labor with PCEA [group A (observation group), n=27], and vaginal delivery [group B (control group), n=36]. Pelvic floor function was assessed at postpartum 7 weeks.


RESULTS
Groups A and B showed no significant difference in the total score at postpartum 6-8 weeks. However, group A showed lower pelvic floor muscle tone at rest and significantly higher muscle strength scores than group B. Both the pre-rest and post-rest phase muscle strength was stronger than in group B (P=0.039 and P=0.016, respectively). There was no significant difference in pelvic floor muscle strength between analgesia and non-analgesia groups, or between episiotomy and non-episiotomy recipients.


CONCLUSIONS
Painless labor with PCEA reduced both pain during the delivery and injury to the pelvic floor. It had protective effect on the pelvic floor muscles.