scholarly journals Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

2011 ◽  
Vol 48 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Sthela Maria Murad-Regadas ◽  
Francisco Sergio P Regadas ◽  
Lusmar Veras Rodrigues ◽  
Débora Couto Furtado ◽  
Ana Cecília Gondim ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Obstructed Defecation ◽  
Delivery Mode ◽  
Obstructed Defecation Syndrome ◽  
Group I ◽  
Vaginal Deliveries ◽  
Grade Ii ◽  
Group Ii

CONTEXT: The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. OBJECTIVES: To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. METHODS: Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (<50y x >50y) and stratified by mode of delivery and parity: group I (<50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). RESULTS: Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group <50y and in the nulliparous and vaginal groups >50y. No correlation was found between rectocele and the number of vaginal deliveries. CONCLUSION: Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

scholarly journals Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

2012 ◽  
Vol 49 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Sthela Maria Murad-Regadas ◽  
Francisco Sergio P. Regadas ◽  
Lusmar Veras Rodrigues ◽  
Graziela Olivia da Silva Fernandes ◽  
Guilherme Buchen ◽  
...  
Keyword(s):  
Obstructed Defecation ◽  
Mucosal Prolapse ◽  
Clinical Treatment ◽  
Group Iii ◽  
Treatment Groups ◽  
Obstructed Defecation Syndrome ◽  
Group I ◽  
Grade Ii ◽  
Group Ii ◽  
Grade Iii

CONTEXT: Management of patients with obstructed defecation syndrome is still controversial. OBJECTIVE: To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. METHODS: The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. RESULTS: Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associated with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. CONCLUSIONS: Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts.

scholarly journals The impact of delivery mode on the risk of neonatal intracranial haemorrhage

2019 ◽  
Vol 53 (3) ◽  
Author(s):  
Nika Buh ◽  
Miha Lučovnik
Keyword(s):  
Vaginal Delivery ◽  
Intracranial Haemorrhage ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Vacuum Extraction ◽  
Delivery Mode ◽  
Spontaneous Vaginal Delivery ◽  
Emergency Caesarean ◽  
Vaginal Deliveries ◽  
The Impact

Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.

scholarly journals Global Changes of 5-mC/5h-mC Ratio and Methylation of Adiponectin and Leptin Gene in Placenta Depending on Mode of Delivery

2021 ◽  
Vol 22 (6) ◽  
pp. 3195
Author(s):  
Aneta Słabuszewska-Jóźwiak ◽  
Marcelina Malinowska ◽  
Anna Kloska ◽  
Joanna Jakóbkiewicz-Banecka ◽  
Mariusz Gujski ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Elective Cesarean Section ◽  
Global Changes ◽  
Delivery Mode ◽  
Cesarean Sections ◽  
Global Methylation ◽  
Vaginal Deliveries ◽  
Elective Cesarean

It was suggested that the epigenetic alterations of the placenta are associated with obesity, as well as the delivery mode. This study aimed to assess the effect of maternal outcome and delivery procedure on global placental DNA methylation status, as well as selected 5’-Cytosine-phosphate-Guanine-3’ (CpG) sites in ADIPOQ and LEP genes. Global DNA methylation profile in the placenta was assessed using the 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) ratio evaluated with the ELISA, followed by target gene methylation patterns at selected gene regions which were determined using methylation-specific qPCR in 70 placentas from healthy, pregnant women with single pregnancy. We found no statistically significant differences in 5-mC/5-hmC ratio between intrapartum cesarean sections (CS) and vaginal deliveries (p = 0.214), as well as between elective cesarean sections and vaginal deliveries (p = 0.221). In intrapartum cesarean sections, the ADIPOQ demethylation index was significantly higher (the average: 1.75) compared to elective cesarean section (the average: 1.23, p = 0.010) and vaginal deliveries (the average: 1.23, p = 0.011). The LEP demethylation index did not significantly differ among elective CS, intrapartum CS, and vaginal delivery groups. The demethylation index of ADIPOQ correlated negatively with LEP in the placenta in the vaginal delivery group (r = −0.456, p = 0.017), but not with the global methylation. The methylation of a singular locus might be different depending on the mode of delivery and uterine contractions. Further studies should be conducted with locus-specific analysis of the whole genome to detect the methylation index of specific genes involved in metabolism.

scholarly journals The Efficacy of Physical Therapy in Treatment of Pelvic Floor Distress in Women of Reproductive Age

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 71-76
Author(s):  
M.R. Orazov ◽  
◽  
E.S. Silantieva ◽  
R.A. Soldatskaya ◽  
M.E. Belkovskaya ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
High Intensity ◽  
Controlled Study ◽  
Study Objective ◽  
Electromagnetic Stimulation ◽  
Group I ◽  
Study Results ◽  
Group Ii

Study Objective: To compare the efficacy of two physical therapy techniques in the treatment of pelvic floor distress (PFD). Study Design: This was a prospective, randomized, double-blind, controlled study. Materials and Methods: Health information about ninety-five women who had had vaginal delivery and suffered from PFD was reviewed in the study. In Group I (n = 50) patients were treated using high-intensity focused electromagnetic (HIFEM) technology, and in Group II (n = 45) electrical stimulation therapy was delivered via an intracavity sensor. Assessments in the study included physical examination, instrumental investigations, and a discussion with patients (completion of a questionnaire and a scale-based assessment). To establish reference values for the parameters used in the study, a control group was made up of 30 apparently healthy women who had had a vaginal delivery. Study Results: Ultrasound of the pelvic floor showed that in Groups I and II the anteroposterior diameter of the levator hiatus (LH) decreased by 3.12 mm and 1.16 mm, respectively (2.7-fold difference), and the transverse diameter of the LH decreased by 3.04 mm and 1.04 mm (2.9-fold difference). The area of the LH decreased by 1.38 cm2 in Group I and 0.08 cm2 in Group II. After treatment the mean Pelvic Floor Distress Inventory (PFDI-20) score was 1.9 times lower (p<0.001) in Group I and the number of women who reported a feeling of looseness in the vagina and urinary incontinence using a bimodal scale for complaint assessment was 1.5 and 1.9 times lower, respectively, than in Group II. Conclusion: Electromagnetic stimulation demonstrated higher efficacy than stimulation via an intracavitary sensor in the treatment of PFD. Keywords: pelvic floor distress, genital prolapse, high-intensity focused electromagnetic stimulation.

Types of pelvic floor dysfunctions in nulliparous, vaginal delivery, and cesarean section female patients with obstructed defecation syndrome identified by echodefecography

2009 ◽  
Vol 24 (10) ◽  
pp. 1227-1232 ◽  
Author(s):  
Sthela M. Murad-Regadas ◽  
Francisco Sérgio P. Regadas ◽  
Lusmar V. Rodrigues ◽  
Leticia Oliveira ◽  
Rosilma G. L. Barreto ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Obstructed Defecation ◽  
Obstructed Defecation Syndrome ◽  
Female Patients

scholarly journals Impact of the Mode of Delivery on Gastroschisis Anatomical Features in the Newborn Children

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
O K Slepov ◽  
I Y Gordienko ◽  
V P Soroka ◽  
O P Gladyshko ◽  
O P Ponomarenko
Keyword(s):  
Positive Impact ◽  
Mode Of Delivery ◽  
Natural Mode ◽  
Delivery Mode ◽  
Clinical Group ◽  
Anatomical Features ◽  
Group I ◽  
Vaginal Deliveries ◽  
The Impact ◽  
Newborn Children

Introduction. The mode of delivery for gravidas with fetuses with GS plays an important role among the factors influencing the results of gastroschisis (GS) treatment. More researchers come to univocal conclusion that elective and early cesarean section has positive impact on elimination (prevention) of GS complications compared to previous experience in natural deliveries in term. However, the impact of the mode of delivery to anatomical features of GS remains still not investigated.The objective of the research was to determine the impact of the delivery mode on anatomical characteristics of newborn children with GS.Materials and methods. Retrospective analysis of 100 patients’ case histories was conducted. Infants were born naturally or via C-section during the period from 1987 to 2015. All newborns were divided into 3 clinical groups according to prenatal diagnosis, mode of delivery, transportation, place and term of surgical treatment of GS.Results. Localization of penetration defect of anterior abdominal wall (AAW) remains constant and typical for GS in every clinical group; therefore the mode of delivery did not have any impact upon the localization of defects in case of this malformation. The size of the penetration defect was significantly smaller in children after C-section than those born via vaginal deliveries. Thus, in Group I (children born via C-section) the defects sizes were 3.15 ± 0.09 cm, while in Groups II and III (after vaginal deliveries) the sizes were 4.17 ± 0.3 cm, p<0.01, and 4.7 ± 0.29 cm, p<0.01, respectively. The eventration rate of retroperitoneal organs (pancreas and duodenum) was significantly higher in children with GS born via natural mode of delivery (II and III clinical group) than in neonates born via C-section (I clinical group), constituting 56.0% and 63.3% to 25.0%, respectively, with p<0.01.Conclusions. The mode of delivery (C-section or vaginal) has impact on anatomical features of GS in the newborns. The size of AAW defect is significantly greater in children with GS born vaginally than in infants born via C-section and eventeration rate of retroperitoneal organs (pancreas and duodenum) is higher.

Bridging the gap between perioperative pelvic floor training and urologic surgeries with risk of incontinence by digital technologies: a survey. (Preprint)

2020 ◽  
Author(s):  
Jan Niclas Mumm ◽  
Lucas Bohn ◽  
Lennert Eismann ◽  
Alexander Buchner ◽  
Theresa Vilsmaier ◽  
...  
Keyword(s):  
At Risk ◽  
Pelvic Floor ◽  
Digital Technologies ◽  
Preventive Treatment ◽  
Final Analysis ◽  
Chi Square ◽  
Group Iii ◽  
Pelvic Floor Training ◽  
Group I ◽  
Group Ii

BACKGROUND Pelvic floor training (PFT) is the gold standard for conservative treatment of male stress urinary incontinence. OBJECTIVE To evaluate patients´ perspective at risk of incontinence on PFT and application of digital technologies for PFT. METHODS Patients undergoing transurethral surgery of the prostate (group I), radical prostatectomy (group II) or treatment at a specialized incontinence outpatient clinic (group III) were surveyed anonymously. Chi-Square test and Kruskal-Wallis-analysis were used for statistical analysis. RESULTS 180 patients were included in the final analysis. In group I (n=35) no patient underwent PFT prior to transurethral surgery. 23.5% of patients in group II (n=51) and 95.7% of patients in group III (n=94) performed PFT. 11.4% in group I, 80.4% in group II and 91.5% in group III have been advised to perform PFT by their urologist. Regarding the information level on PFT, patients from group I (median 1, range 0-5) are less satisfied than patients from group II (median 3, 0-9) or group III (median 5, range 0-10, p<0.001). 88.6% of patients from group I are willing to perform PFT as preventive treatment or to avoid incontinence surgery, 100% from group II and 68.4% from group III (p<0.001). The likelihood to use digital PFT is higher in group I (median: 9, range 0-10) and II (median: 9, range 0-10) than in group III (median: 4, range 0-10, p<0.001). CONCLUSIONS Patients at risk of incontinence currently have limited access to PFT, although they are willing to perform PFT. Digital PFT is highly accepted by patients preoperatively and might be a valuable tool to increase PFT participation.

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

scholarly journals The results of use of myoplasty for closure of the pelvic floor defect after extralevator abdominoperineal excision of the rectum

2019 ◽  
Vol 17 (6) ◽  
pp. 35-40
Author(s):  
N. A. Domansky ◽  
V. V. Semiglazov ◽  
A. M. Karachun ◽  
K. K. Lebedev ◽  
D. V. Samsonov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Pelvic Floor Reconstruction ◽  
Group Iii ◽  
Group I ◽  
Perineal Wound Complications ◽  
Group Ii

Background. Extralevator abdominoperineal excision is associated with a high incidence of perineal wound complications. There is no uniform standard for choosing the method for pelvic floor reconstruction after extralevator abdominoperineal excision.The purpose of the study was to compare the results of extralevator abdominoperineal excisions of the rectum using various methods of perineal wound closure.Materials and Methods. Between 2014 and 2018, 120 patients underwent extralevator abdominoperineal excisions of the rectum using various options for closure of the pelvic floor. The patients were divided into 3 groups. Group I patients (n=64) underwent simple plasty of the peritoneal wound. Group II patients (n=43) underwent myoplasty using the gluteus maximus muscle. Group III patients (n=13) underwent myoplasty using the rectus abdominis muscle. The incidence of perineal wound complications in the early postoperative period was assessed.Results. The total number of perineal wound complications in Group I, II and III was 33 (51.5 %), 13 (30.2 %), and 6 (46.1 %), respectively. Grade IIIA-IIIB complications according to the Clavien-Dindo classification were observed in 25 % of Group I patients, in 18.6 % of Group II patients and in 7.7 % of Group II patients. Postoperative perineal wound complications occurred more often in Group I patients after simple plasty than in Group II and III patients after myoplasty (51.5 % versus 30.2 %). However, perineal wound complications were observed more often in Group III than in Group II (46.1 % versus 30.2 %, respectively). No significant differences in the frequency of complications between 3 groups were found.Conclusion. Using various options for closure of the pelvic floor after extralevator abdominoperineal excisions of the rectum, there was a tendency to reduction in the incidence of grade IIIA-IIIB perineal wound complications.

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