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Impact of the Duration of the Second Stage of Labor on Postpartum Pelvic Floor Symptoms.
McKenzie, Collin M; Woolfolk, Candice L; Rieger, Mary M; White, Amanda B; Tuuli, Methodius G; Srinivas, Sindhu K; Caughey, Aaron B; Tita, Alan; Gregory, W Thomas; Richter, Holly E; Cahill, Alison G.
Afiliación
  • McKenzie CM; From the Department of Women's Health, Dell School of Medicine, University of Texas at Austin, Austin, TX.
  • Woolfolk CL; Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
  • Rieger MM; From the Department of Women's Health, Dell School of Medicine, University of Texas at Austin, Austin, TX.
  • White AB; From the Department of Women's Health, Dell School of Medicine, University of Texas at Austin, Austin, TX.
  • Srinivas SK; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Caughey AB; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR.
  • Gregory WT; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR.
  • Cahill AG; From the Department of Women's Health, Dell School of Medicine, University of Texas at Austin, Austin, TX.
Urogynecology (Phila) ; 30(3): 381-387, 2024 03 01.
Article en En | MEDLINE | ID: mdl-38484257
ABSTRACT
IMPORTANCE The associated effect of duration of the second stage of labor (SSL) on pelvic floor symptoms development is not well studied.

OBJECTIVE:

This study aimed to examine the association between duration of SSL and pelvic floor symptoms at 6 months postpartum among primiparous women. STUDY

DESIGN:

A planned secondary analysis of a multicenter randomized trial evaluating the impact of immediate versus delayed pushing on vaginal delivery rates, maternal morbidity, and neonatal outcomes was conducted between 2014 and 2018. For pelvic floor arm participants, demographic, pelvic examination, and validated questionnaire data were collected postpartum. Primary outcome was change in Pelvic Floor Distress Inventory 20 (PFDI-20) score from immediate to 6 months postpartum. Secondary outcomes included changes in the Pelvic Floor Impact Questionnaire, Fecal Incontinence Severity Index, Modified Manchester Health Questionnaire scores, and Pelvic Organ Prolapse Quantification measurements at 6 months postpartum. Participants were analyzed by SSL duration ≤60 minutes or >60 minutes.

RESULTS:

Of the 2,414 trial participants, 767 (32%) completed pelvic floor assessments at 6 months. Pelvic Floor Distress Inventory 20 scores significantly improved at 6 months in the ≤60 minutes SSL group compared with >60 minutes SSL (-14.3 ± 48.0 and -3.2 ± 45.3, respectively; P = 0.04). Changes from immediate postpartum in total and subscale scores for other questionnaires at 6 months did not differ between groups. Prolapse stage did not differ between groups. Perineal body was significantly shorter in the >60 minutes SSL group (3.7 ± 0.7, 3.5 ± 0.8; P = 0.03).

CONCLUSIONS:

Women with SSL >60 minutes experience less improvement in PFDI-20 scores at 6 months. Greater tissue and innervation trauma in those with SSL >60 minutes may explain persistently less improvement in PFDI-20 scores.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Fecal / Prolapso de Órgano Pélvico Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Urogynecology (Phila) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Fecal / Prolapso de Órgano Pélvico Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Urogynecology (Phila) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos