Prophylaxis of pelvic floor trauma

Background The desire of pregnant women to preserve the pelvic floor function in the context of vaginal births is great, especially as pelvic floor trauma is associated with a high rate of physical and psychosocial stress, including posttraumatic stress disorder.Objective To present the risk factors for impaired pelvic floor function and to highlight possible evidence-based protective measures in the context of vaginal births.Material and methods Literature search in the online database PubMed.Results Pregnancy and birth are the main risk factors for pelvic floor disorders; however, in the context of vaginal birth, the birth mechanics and the birth process can be positively influenced to a certain extent by various evidence-based measures in the sense of primary prevention.Conclusion Due to partly limited treatment possibilities, especially with respect to levator muscle avulsion or overstretching, the prophylaxis of pelvic floor damage peripartum plays a special role. It is advisable to make a targeted and effective selection of those women whose basic requirements for a pelvic floor-protecting birth seem to be suboptimal. With these women, the possibility of a primary cesarean section can be liberally discussed. For all other women, the application of the described evidence-based measures for primary prophylaxis of pelvic floor damage is recommended.