RISK FACTORS OF PELVIC FLOOR DYSFUNCTION AND THE COMPUTER PROGRAM OF ITS PREDICTION IN WOMEN IN THE PERMANENT PERIOD
Main Article Content
Abstract
Objective to assess risk factors for pelvic floor dysfunction and develop a computer program for predicting it in women in the postpartum period
Materials and methods. Study design: retrospective, case-control. The study was approved by the Ethics Committee of the Kemerovo State Medical University. An anonymous survey was conducted of 80 women with pelvic dysfunction and 80 women without pelvic floor dysfunction at the age from 18 to 45 years (mean age – 31.9 ± 5.9 years, 28.7 ± 5.4 years, p = 0.007).
Results. The main risk factors for pelvic floor dysfunction in women of reproductive age, in addition to the generally accepted ones, are the presence of hypodynamia (χ2 = 19.61; p < 0.001) and smoking (χ2 = 14.95; p < 0.001). Application of the computer program «Prediction of Pelvic Floor Dysfunction after Childbirth», developed using binary logistic regression and including 7 factors (the number of births and pregnancies in history, the presence of hypodynamia, obesity, smoking, stigma of connective tissue dysplasia, isthmic-cervical insufficiency) has a sensitivity of 85.0 % and specificity 78.8 % in predicting symptoms of pelvic floor dysfunction in the postpartum period.
Conclusion. Thus, as a result of the study, a highly effective approach has been developed to predict and prevent symptoms of pelvic floor dysfunction in women after childbirth.
Keywords
Author Biographies
Светлана Юрьевна Хапачева,
post-graduate student, department of obstetrics and gynecology named after G.A. UshakovaНаталья Владимировна Артымук,
Artymuk Natalia Vladimirovna
MD, PhD, professor, deputy editor of the journal Mother and Baby in Kuzbass.
She is the Head of the Department of Obstetrics and Gynaecology №2, the Deputy Editor-in-Chief. She is also the President of the Kemerovo regional public organization “Association of obstetricians and gynecologists”, the chief obstetrician-gynecologist of the Siberian Federal district; the member of the Board of the Russian Society of Obstetricians and Gynaecologists, the member of the European Society of Contraception and Reproductive Health, the European Society of Gynaecological Oncology and the International Society of Gynecological Endocrinology.
She has graduated from Kemerovo State Medical institute with honors. She studied in clinical residency in obstetrics and gynecology at School of Arenberg (Salzburg, Austria) and School of Bloomberg (Johns Hopkins University, Baltimore, USA). One is a specialist in ultrasound diagnostics in obstetrics and gynecology, endocrinology and endoscopic surgery. In 1996 in Barnaul she defended her PhD thesis and her doctoral thesis in 2003 in Moscow.
Her priorities are: endocrine gynecology, infertility, cervix uteri pathology, menopausal disorders, disorder of menstrual function, endoscopic and abdominal gynecological surgery.
She deals with reproductive health problems, non-surgical and surgical treatment of benign neoplasms of genital organs. She is an author of more than 450 scientific works, including 3 monographs and study manuals for doctors. She has her highest medical qualification category in “Obstetrics and gynecology”.
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
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References
Reimers C. Staer-Jensen J, Siafarikas F, et al. Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study. BJOG. 2016; 123(5): 821-829
Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013; 24: 901-912
Dubinskaya ED, Babicheva IA, Kolesnikova SN, Dorfman MF, Lapteva NV. Clinical Specificities And Risk Factors Of Early Forms Of Pelvic Organ Prolapse. Gynecology, Obstetrics and Perinatology. 2015; 14(6): 5-11. Russian (Дубинская Е.Д., Бабичева И.А., Колесникова С.Н., Дорфман М.Ф., ЛАПТЕВА Н.В. Клинические особенности и сексуальная функция у пациенток с ранними формами пролапса тазовых органов //Вопросы гинекологии, акушерства и перинатологии. 2015. Т. 14, № 6. С. 5-11)
Dobrokhotova YuE, Ilyina IYu. The effectiveness of conservative treatment of genital prolapse after childbirth using a vaginal simulator. Russian Medical Journal. 2017; 26: 1908-1912. Russian (Доброхотова Ю.Э., Ильина И.Ю. Эффективность консервативного лечения пролапса гениталий после родов с использованием вагинального тренажера //РМЖ. 2017. № 26. С. 1908-1912)
Abdullah B, Ayub SH, Mohd Zahid AZ, et al. Urinary incontinence in primigravida: the neglected pregnancy predicament. Eur J Obstet Gynecol Reprod Biol. 2016; 198: 110-115
Urogynocology Subgroup, Chinese Society of Obstetrics and Gynocology, Chinese Medical Association. Zhonghua Fu Chan Ke Za Zhi. 2017; 52(5): 289-293
Madhu C, Swift SS, Moloney-Geany SS et al. How to use the Pelvic Organ Prolapse Quantification (POP-Q) system? Neurourol Urodyn. 2018; 7(S6): 39-43
Gyhagen M, Bullarbo M, Nielsen TF, et al. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG. 2013; 120: 144-151
Li Y, Zhang Z. Association between waist-to-height ratio and postpartum urinary incontinence. Int Urogynecol J. 2017; 28(6): 835-843
Zizzi PT, Trevisan KF, Leister N, et al. Women's pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study. Rev Esc Enferm USP. 2017; 51: e03214. doi: 10.1590/S1980-220X2016209903214
Everist R, Burrell M, Mallitti KA, et al. Postpartum anal incontinence in women with and without obstetric anal sphincter injuries. Int Urogynecol J. 2020; 10.1007/s00192-020-04267-8. doi:10.1007/s00192-020-04267-8
Rogers RG, Leeman LM, Borders N, et al. Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women. BJOG. 2014; 121(9): 1145-1154
Artymuk NV, Khapacheva SY. Тhe prevalence of pelvic floor dysfunction (PFD) symptoms in reproductive-aged women. Obstetrics and Gynecology. 2018; 9: 99-105. Russian (Артымук Н.В., Хапачева С.Ю. Распространенность симптомов дисфункции тазового дна у женщин репродуктивного возраста //Акушерство и гинекология. 2018. № 9. 99-105.) doi: https://dx.doi.org/10.18565/aig.2018.9.99-105
Ваde Araujo CC, Coelho SA, Stahlschmidt P, Juliato CRT. Does vaginal delivery cause more damage to the pelvic floor than cesarean section as determined by 3D ultrasound evaluation? A systematic review. Int Urogynecol J. 2018; 29(5): 639-645. doi: 10.1007/s00192-018-3609-3
Živković K, Živković N, Župić T, Hodžić D, Mandić V, Orešković S. Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature. Acta Clin Croat. 2016; 55(4): 615-624. doi: 10.20471/acc.2016.55.04.12
Memon HU, Handa VL. Vaginal childbirth and pelvic floor disorders. Womens Health. 2013; 9(3): 10. 2217/whe.13.17
Jean Dit Gautier E, Mayeur O, Lepage J, et al. Pregnancy impact on uterosacral ligament and pelvic muscles using a 3D numerical and finite element model: preliminary results. Int Urogynecol J. 2018; 29(3): 425-430.
Bozkurt M, Yumru AE, Şahin L. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor. Taiwanese J of Obstet and Gynecol. 2014; 53(4): 452-458
Alcalay M, Stav K, Eisenberg VH. Family history associated with Pelvic Organ Prolapse in young women. Int Urogynecol J. 2015; 26(12): 1773-1776
Chen Y, Johnson B, Li F, et al. The Effect of Body Mass Index on Pelvic Floor Support 1 Year Postpartum. Reprod Sci. 2016; 23(2): 234-238
Young N, Atan IK, Rojas RG, et al. Obesity: how much does it matter for female pelvic organ prolapse? Int Urogynecol J. 2018; 29(8): 1129-1134
Chen Y, Li F, Lin X, et al. The recovery of pelvic organ support during the first year postpartum. BJOG. 2013; 120(11): 1430-1437
Estanol MV, Crisp CC, Oakley SH, et al. Systemic markers of collagen metabolism and vitamin C in smokers and non-smokers with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2015; 184: 58-64
Brown S, Gartland D, Perlen S, McDonald E, MacArthur C. Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study. BJOG. 2015; 122(7): 954-962
Parés D, Martinez-Franco E, Lorente N, Viguer J, Lopez-Negre JL, Mendez ZR. Prevalence of fecal incontinence in women during pregnancy: a large cross-sectional study. Dis. Colon Rectum. 2015; 58(11): 1098-1103
Dabiri F, Yabandeh AP, Shahi A, Kamjoo A, Teshnizi SH. The Effect of Mode of Delivery on Postpartum Sexual Functioning in Primiparous Women. Oman Med J. 2014; 29(4): 276-279
Andreucci CB, Bussadori JC, Pacagnella RC, Chou D, Filippi V, Say L, Cecatti JG. Sexual life and dysfunction after maternal morbidity: a systematic review. BMC Pregnancy and Childbirth. 2015; 15: 307. DOI 10.1186/s12884-015-0742-6