Pronostic obstétrical des femmes atteintes de vaginisme primaire

INTRODUCTION: Vaginismus is a severe dysfunction and a problem which can interfere with woman’s and couple’s sex life. It may influence the obstetric outcome. This study aims to determine if the clinical features of vaginismus can impact childbirth experience. METHODS: We conducted a retrospective multicenter study involving patients affected by primary vaginismus, having given birth to their first child (who had reached term), between 2005 and 2015. RESULTS: Out of 19 patients included in the study, 9 had prolonged pregnancies, 14 had spontaneous labor (including 8 at term), 3 had cesarean section before going into labor and 2 had labor induction. Among the 16 women who experienced labor, 4 had cesarean section, 5 had vaginal delivery with the help of forceps and 7 had spontaneous vaginal delivery. Among the 12 women who had vaginal delivery, 9 underwent episiotomy, 7 had spontaneous perineal tear alone or in combination with episiotomy. No 3(rd) and 4(th) degree perineal injury or intact perineum were found. The average birth weight for babies was 3380 g ± 332 (2870 g-3970g, 47(th) percentile). CONCLUSION: The rates of labour dystocia and perineal morbidity were significantly high. These data were comparable to most of the data in the literature. It is likely that the psychological and behavioral aspects of vaginismus (fear-avoidance and anxiety-inducing mechanism) have favoured prolonged pregnancies, cesarean sections, mechanical dystocias and perineal injuries. Additional studies are necessary to better identify vaginismus and its obstetrical implications.