Delivery of Nulliparous Women at Term with Vaginismus [15C]

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Abstract

INTRODUCTION:

To compare the mode of delivery of nulliparous women with vaginismus at term to those without vaginismus.

METHODS:

This was a retrospective case-control study. Nulliparous women ≥37 weeks presenting in labor with a diagnosis of vaginismus, defined as chronic recurring difficulty for a woman to allow vaginal penetration, were included. The control group consisted of the next two nulliparous women delivering at term. Delivery data were compared between the groups.

RESULTS:

26 women with vaginismus were compared to 52 controls. Demographics were similar between the groups. The cesarean delivery rate was significantly higher in the vaginismus group (38% vs. 13%, p=0.019). Maternal request was the major contributing factor (19% vs. 0%, p=0.002). Four women in the vaginismus group required perineal suturing using IV sedation or general anesthesia compared to none in the control group.

CONCLUSION:

Nulliparous women with vaginismus have a significantly higher cesarean delivery rate. Maternal request is a major contributing factor rather than standard obstetrical indications. Perineal repair following vaginal delivery often requires iv sedation in the operating room.

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