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Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study

INTRODUCTION AND HYPOTHESIS: Severe perineal tears can predict bothersome pelvic floor disorders later in life. We have a poor understanding of pelvic floor changes during the third trimester and the first few postpartum months. We aimed to compare women with severe perineal trauma during childbirth...

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Autores principales: Tilak, Manisha, Mann, Gurkiran K., Gong, Merry, Koenig, Nicole A., Lee, Terry, Geoffrion, Roxana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9469830/
https://www.ncbi.nlm.nih.gov/pubmed/36098790
http://dx.doi.org/10.1007/s00192-022-05348-6
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author Tilak, Manisha
Mann, Gurkiran K.
Gong, Merry
Koenig, Nicole A.
Lee, Terry
Geoffrion, Roxana
author_facet Tilak, Manisha
Mann, Gurkiran K.
Gong, Merry
Koenig, Nicole A.
Lee, Terry
Geoffrion, Roxana
author_sort Tilak, Manisha
collection PubMed
description INTRODUCTION AND HYPOTHESIS: Severe perineal tears can predict bothersome pelvic floor disorders later in life. We have a poor understanding of pelvic floor changes during the third trimester and the first few postpartum months. We aimed to compare women with severe perineal trauma during childbirth with women who experienced minimal trauma, for condition-specific quality of life, sexual function, mental health and overall quality of life in the first 6 months postpartum. METHODS: We recruited primiparous women with third- or fourth-degree tears (obstetric anal sphincter injuries, OASIS) and age-matched controls with no tears or first-degree tears in the immediate postpartum period. Participants completed validated questionnaires at baseline, 2, 4 and 6 months postpartum. Mixed effects linear regression or quantile regression adjusted for baseline score were used to compare the groups as appropriate. RESULTS: A total of 74 women completed at least one questionnaire (35 OASIS, 39 controls). Both groups had similar demographics. Women with OASIS tended to have worse Pelvic Floor Distress Index-40 scores at month 2; median scores were similar in the two groups by month 6. They also had significantly lower Female Sexual Function Index scores (mean difference: −6.1; 95% CI: −11.9, −0.2, p=0.043) at month 2. There were no mental health group differences and quality of life improved over time, mainly in the OASIS group. Six-month participant attrition rate was 52%. CONCLUSIONS: Women with OASIS encounter specific pelvic floor challenges during the first 6 months postpartum. Although our recruitment rate was high, the attrition rate was also high, demonstrating challenges with retention of postpartum women into longitudinal research.
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spelling pubmed-94698302022-09-14 Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study Tilak, Manisha Mann, Gurkiran K. Gong, Merry Koenig, Nicole A. Lee, Terry Geoffrion, Roxana Int Urogynecol J Original Article INTRODUCTION AND HYPOTHESIS: Severe perineal tears can predict bothersome pelvic floor disorders later in life. We have a poor understanding of pelvic floor changes during the third trimester and the first few postpartum months. We aimed to compare women with severe perineal trauma during childbirth with women who experienced minimal trauma, for condition-specific quality of life, sexual function, mental health and overall quality of life in the first 6 months postpartum. METHODS: We recruited primiparous women with third- or fourth-degree tears (obstetric anal sphincter injuries, OASIS) and age-matched controls with no tears or first-degree tears in the immediate postpartum period. Participants completed validated questionnaires at baseline, 2, 4 and 6 months postpartum. Mixed effects linear regression or quantile regression adjusted for baseline score were used to compare the groups as appropriate. RESULTS: A total of 74 women completed at least one questionnaire (35 OASIS, 39 controls). Both groups had similar demographics. Women with OASIS tended to have worse Pelvic Floor Distress Index-40 scores at month 2; median scores were similar in the two groups by month 6. They also had significantly lower Female Sexual Function Index scores (mean difference: −6.1; 95% CI: −11.9, −0.2, p=0.043) at month 2. There were no mental health group differences and quality of life improved over time, mainly in the OASIS group. Six-month participant attrition rate was 52%. CONCLUSIONS: Women with OASIS encounter specific pelvic floor challenges during the first 6 months postpartum. Although our recruitment rate was high, the attrition rate was also high, demonstrating challenges with retention of postpartum women into longitudinal research. Springer International Publishing 2022-09-13 2023 /pmc/articles/PMC9469830/ /pubmed/36098790 http://dx.doi.org/10.1007/s00192-022-05348-6 Text en © The International Urogynecological Association 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Tilak, Manisha
Mann, Gurkiran K.
Gong, Merry
Koenig, Nicole A.
Lee, Terry
Geoffrion, Roxana
Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title_full Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title_fullStr Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title_full_unstemmed Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title_short Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
title_sort pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9469830/
https://www.ncbi.nlm.nih.gov/pubmed/36098790
http://dx.doi.org/10.1007/s00192-022-05348-6
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