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

Author(s):  
Russalina Stroeder ◽  
Julia Radosa ◽  
Lea Clemens ◽  
Christoph Gerlinger ◽  
Gilda Schmidt ◽  
...  

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.

2011 ◽  
Vol 108 (8) ◽  
pp. 1240-1247 ◽  
Author(s):  
Lysanne Campeau ◽  
Ilya Gorbachinsky ◽  
Gopal H. Badlani ◽  
Karl Erik Andersson

2018 ◽  
Vol 40 (6) ◽  
pp. 830
Author(s):  
Brianna Cameron ◽  
May Sanaee ◽  
Johanne Sabourin ◽  
Nicole Koenig ◽  
Hong Quian ◽  
...  

2021 ◽  
Author(s):  
Carlos Izaias Sartorão Filho ◽  
Fabiane Affonso Pinheiro ◽  
Luiz Takano ◽  
Raghavendra Hallur Lakshmana Shetty ◽  
Sthefanie K. Nunes ◽  
...  

Abstract Background Gestational Diabetes Mellitus and long-term urinary incontinence (UI) have a severe impact on women's health. New methods to identify pregnant predictor risk factors of UI are needed. Our study investigated clinical and pelvic floor 3D-ultrasound markers in pregnant women at the second and third trimesters to predict 6-18 months postpartum UI. Methods This ongoing prospective cohort study included one hundred five nulliparous pregnant women with universal GDM screening and diagnosis, treated with nutritional and healthy lifestyle intervention. Pelvic floor 3DUltrasound was performed at the second and third trimesters of gestation. Clinical and pelvic floor 3DUltrasound biometry were collected. The ICIQ-SF and ISI questionnaires for UI were applied in the third trimester and 6-18 months postpartum. We performed univariate analysis (P<.20) to extract risk factors variables and multivariate logistic regression analysis (P<.05) to obtain the adjusted relative ratio for 6-18 months postpartum UI. Results In a preliminary result, a total of 93 participants concluded the follow-up. Using the variables obtained by the univariate analysis and after the adjustments for potential confounders, logistic regression analysis revealed that Gestational Diabetes Mellitus exposure was a strong and independent risk factor for 6-18 months postpartum UI (Adjusted RR 8.088; 95%CI 1.17-55.87; P:.034). In addition, higher hiatal area distension at rest from the second to the third trimester was negatively correlated with 6-18 months postpartum UI (Adjusted RR 0.966; 95%CI 0.93-0.99; P: .023). Conclusion Gestational Diabetes Mellitus was positively correlated with 6-18 months postpartum UI, and a higher hiatal area distension was negatively correlated with 6-18 months postpartum UI development. Trial registration: Regulatory approval was obtained from the Institutional Review Board (number 1.716.895) by “Botucatu Medical School of São Paulo State University (Unesp)” Ethics Committee.


2019 ◽  
Vol 300 (5) ◽  
pp. 1325-1330 ◽  
Author(s):  
Barbara Bodner-Adler ◽  
Oliver Kimberger ◽  
Thomas Laml ◽  
Ksenia Halpern ◽  
Clara Beitl ◽  
...  

Abstract Purpose To investigate the prevalence of pelvic floor disorders (PFDs) in a cohort of Austrian women either during their early or late pregnancy and to search for clinical risk factors which correlate with pelvic floor symptoms during pregnancy. Methods A prospective study was conducted and 200 pregnant women answered the validated German pelvic floor questionnaire during their first or third trimenon of gestation. Furthermore, a multivariate logistic regression model was used to determine independent risk factors for PFDs after adjusting for confounders. Results 96/200 (48%) women reported psychological strain in at least 1 of the 4 pelvic floor domains while the remaining 104 women (52%) were asymptomatic. Affected women showed a significant higher BMI, a more frequent positive family history and a higher rate of multiple pregnancies was noted compared to asymptomatic women (p < 0.05). Furthermore, a statistically significant positive correlation could be observed between BMI, smoking and mean bladder score as well as mean prolapse score, signifying more symptom bother from bladder and prolapse in smokers with high BMI. A significant positive correlation was also detected between mean bowel score and parity. In the multivariate model, high BMI (CI 1.013–1.143), positive family history (CI 0.044–0.260) and multiple pregnancies (CI 0.011–0.244) remained independently associated with pelvic floor symptoms (p < 0.05). Conclusion Our results demonstrate that pelvic floor-related quality of life during pregnancy is a prevalent condition which is strongly affected by the expectant mother’s weight as well as her family history. In addition, women with multiple pregnancies seem to be at increased risk.


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