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Urogynecology in obstetrics: impact of pregnancy and delivery on pelvic floor disorders, a prospective longitudinal observational pilot study

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Title: Urogynecology in obstetrics: impact of pregnancy and delivery on pelvic floor disorders, a prospective longitudinal observational pilot study
Authors: Russalina Stroeder, Julia Radosa, Lea Clemens, Christoph Gerlinger, Gilda Schmidt, Panagiotis Sklavounos, Zoltan Takacs, Gabriele Meyberg-Solomayer, Erich-Franz Solomayer, Amr Hamza
Source: Arch Gynecol Obstet
Publisher Information: Springer Science and Business Media LLC, 2021.
Publication Year: 2021
Subject Terms: Adult, Quality of life, Preventive treatment strategies, Urinary Bladder, Pelvic floor disorders, Pilot Projects, Pelvic Floor Disorders, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Infant, Newborn [MeSH], Delivery, Obstetric/methods [MeSH], Ultrasonography [MeSH], Pregnancy Complications/diagnostic imaging [MeSH], Urinary Bladder/diagnostic imaging [MeSH], Pelvic Floor/anatomy, Urinary Incontinence/etiology [MeSH], Pelvic Floor Disorders/psychology [MeSH], Quality of Life [MeSH], Translabial ultrasound, Urinary Incontinence/epidemiology [MeSH], Muscle Contraction [MeSH], Pelvic Floor Disorders/epidemiology [MeSH], Female [MeSH], Adult [MeSH], Humans [MeSH], POP-Q, Prospective Studies [MeSH], Urinary Bladder/physiopathology [MeSH], Parturition [MeSH], Longitudinal Studies [MeSH], General Gynecology, Obstetrics [MeSH], Urinary Bladder/anatomy, Delivery, Obstetric/adverse effects [MeSH], Parity [MeSH], Pelvic Floor Disorders/etiology [MeSH], Pelvic Floor/diagnostic imaging [MeSH], Pilot Projects [MeSH], Cesarean Section/adverse effects [MeSH], Pregnancy [MeSH], Humans, Longitudinal Studies, Prospective Studies, Ultrasonography, ddc:610, Cesarean Section, Infant, Newborn, Parturition, Pelvic Floor, Delivery, Obstetric, 3. Good health, Obstetrics, Pregnancy Complications, Parity, Quality of Life, Female, Muscle Contraction
Description: Purpose To assess changes in the pelvic floor anatomy that cause pelvic floor disorders (PFDs) in primigravidae during and after pregnancy and to evaluate their impact on women’s quality of life (QoL). Methods POP-Q and translabial ultrasound examination was performed in the third trimester and 3 months after delivery in a cohort of primigravidae with singleton pregnancy delivering in a tertiary center. Results were analyzed regarding mode of delivery and other pre- and peripartal factors. Two individualized detailed questionnaires were distributed at 3 months and at 12 months after childbirth to determinate QoL. Results We recruited 45 women, of whom 17 delivered vaginally (VD), 11 received a vacuum extraction delivery (VE) and 17 a Cesarean section in labor (CS). When comparing third-trimester sonography to 3 months after delivery, bladder neck mobility increased significantly in each delivery group and hiatal area increased significantly in the VD group. A LAM avulsion was found in two women after VE. Connective tissue weakness (p = 0.0483) and fetal weight at birth (p = 0.0384) were identified as significant risk factors for the occurrence of PFDs in a multivariant regression analysis. Urinary incontinence was most common with 15% and 11% of cases at 3, respectively, 12 months after delivery. 42% of women reported discomfort during sexual intercourse, 3 months after delivery and 24% 12 months postpartum. Although 93% of women engage a midwife after delivery, only 56% participated in pelvic floor muscle training. Conclusion Connective tissue weakness and high fetal weight at birth are important risk factors for the occurrence of PFDs. Nevertheless, more parturients should participate in postpartal care services to prevent future PFDs.
Document Type: Article
Other literature type
Language: English
ISSN: 1432-0711
0932-0067
DOI: 10.1007/s00404-021-06022-w
DOI: 10.22028/d291-33917
Access URL: https://link.springer.com/content/pdf/10.1007/s00404-021-06022-w.pdf
https://pubmed.ncbi.nlm.nih.gov/33751201
https://www.ncbi.nlm.nih.gov/pubmed/33751201
https://link.springer.com/article/10.1007/s00404-021-06022-w
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8277616
https://link.springer.com/content/pdf/10.1007/s00404-021-06022-w.pdf
https://europepmc.org/article/MED/33751201
https://pubmed.ncbi.nlm.nih.gov/33751201/
https://repository.publisso.de/resource/frl:6450596
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Accession Number: edsair.doi.dedup.....4f3d42293e80ef406bfc3f4ecb6e4cf1
Database: OpenAIRE
Description
Abstract:Purpose To assess changes in the pelvic floor anatomy that cause pelvic floor disorders (PFDs) in primigravidae during and after pregnancy and to evaluate their impact on women’s quality of life (QoL). Methods POP-Q and translabial ultrasound examination was performed in the third trimester and 3 months after delivery in a cohort of primigravidae with singleton pregnancy delivering in a tertiary center. Results were analyzed regarding mode of delivery and other pre- and peripartal factors. Two individualized detailed questionnaires were distributed at 3 months and at 12 months after childbirth to determinate QoL. Results We recruited 45 women, of whom 17 delivered vaginally (VD), 11 received a vacuum extraction delivery (VE) and 17 a Cesarean section in labor (CS). When comparing third-trimester sonography to 3 months after delivery, bladder neck mobility increased significantly in each delivery group and hiatal area increased significantly in the VD group. A LAM avulsion was found in two women after VE. Connective tissue weakness (p = 0.0483) and fetal weight at birth (p = 0.0384) were identified as significant risk factors for the occurrence of PFDs in a multivariant regression analysis. Urinary incontinence was most common with 15% and 11% of cases at 3, respectively, 12 months after delivery. 42% of women reported discomfort during sexual intercourse, 3 months after delivery and 24% 12 months postpartum. Although 93% of women engage a midwife after delivery, only 56% participated in pelvic floor muscle training. Conclusion Connective tissue weakness and high fetal weight at birth are important risk factors for the occurrence of PFDs. Nevertheless, more parturients should participate in postpartal care services to prevent future PFDs.
ISSN:14320711
09320067
DOI:10.1007/s00404-021-06022-w