Perineal outcome and the risk of pelvic floor dysfunction: a cohort study of primiparous women

Rikard-Bell, Joan, Iyer, Jay, and Rane, Ajay (2014) Perineal outcome and the risk of pelvic floor dysfunction: a cohort study of primiparous women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 (4). pp. 371-376.

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Abstract

Background: Pelvic floor dysfunction (PFD) is the most common complication of childbirth. Assumptions have been made that perineal trauma increases the risk of PFD compared to an intact perineum, however the evidence for this is lacking. The aim of this study was to explore the relationship between perineal outcome and postpartum PFD.

Materials and Methods: Prospective cohort study design, with a self-reported quality of life (QOL) questionnaire mailed to all primiparous women with a non-instrumental delivery at The Townsville Hospital between 2011 and 2012 (n = 766). ANOVA was used to compare how the symptoms of PFD affect QOL in women with an intact perineum, episiotomy or spontaneous tear.

Results: Seventy-nine percent of the population had perineal injury; 60% had a spontaneous tear and 19% had an episiotomy. Ninety-seven percent of women who completed the questionnaire (n = 196) complained of PFD symptoms. Women with episiotomy had the best QOL, reporting the lowest levels of urinary dysfunction (statistically significant). No differences between the groups were found for symptoms of bowel, prolapse or sexual dysfunction.

Conclusions: This study shows a relationship between perineal outcome and PFD and suggests that an episiotomy is associated with the least morbidity due to symptoms of urinary incontinence. Additional large-scale prospective research is required to further investigate and delineate the impact of childbirth on PFD.

Item ID: 36887
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: perineum, episiotomy, pelvic floor, incontinence, quality of life
Funders: James Cook University School of Medicine and Dentistry
Date Deposited: 05 Mar 2015 02:33
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110399 Clinical Sciences not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920114 Reproductive System and Disorders @ 100%
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