Joyce Irving Goldman Medical School, Ben Gurion University of the Negev, Beer Sheva, Israel.
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University Medical School of Jerusalem, 12 Bayit Street, 91031, Jerusalem, Israel.
Arch Gynecol Obstet. 2019 Jul;300(1):127-133. doi: 10.1007/s00404-019-05173-1. Epub 2019 May 3.
Pregnancy and labor are known risk factors for pelvic floor dysfunction (PFD). Yet not much is known regarding recovery from PFD. We hypothesized that the recovery from PFD during the postpartum period would be associated with the duration of the second stage of labor (SSL).
We conducted a case-control study of patients who gave birth at the Soroka University Medical Center, Beer-Sheva, Israel. Those who consented completed the Pelvic Floor Distress Inventory-20 (PFDI-20), a questionnaire developed to measure the extent of injury to the pelvic floor, after delivery and 3-month postpartum. The difference between the scores was calculated, representing recovery of symptoms. The duration of the SSL, and clinical and obstetrical characteristics were retrieved from the patients' medical records. Wilcoxon rank test was used, assessing the significance of the recovery. The association between the degree of the recovery and the duration of SSL was tested using Mann-Whitney ranking.
A total of 92 patients completed the PFDI-20 after delivery and 3-month postpartum. We found a significant difference between PFD symptoms during pregnancy and 3-month postpartum (P < 0.001). This difference remained consistent in all components of the PFDI-20. In addition, a more profound recovery of colorectal and anal dysfunction (CRAD) symptoms was associated with a shorter duration of the SSL (P = 0.03).
There is a statistically significant recovery of PFD symptoms in the postpartum period. Furthermore, greater recovery from CRAD symptoms is associated with a shorter duration of the SSL.
妊娠和分娩是盆底功能障碍（PFD）已知的危险因素。然而，对于 PFD 的恢复知之甚少。我们假设 PFD 在产后期间的恢复与第二产程（SSL）的持续时间有关。
我们对在以色列贝尔谢巴的索罗卡大学医学中心分娩的患者进行了病例对照研究。那些同意的患者在分娩后和产后 3 个月完成了盆底窘迫量表 20 项（PFDI-20），这是一种用于测量盆底损伤程度的问卷。计算得分之间的差异，代表症状的恢复。SSL 的持续时间以及临床和产科特征从患者的病历中检索出来。Wilcoxon 秩检验用于评估恢复的显著性。使用 Mann-Whitney 排名检验来测试恢复程度与 SSL 持续时间之间的关联。
共有 92 名患者在分娩后和产后 3 个月完成了 PFDI-20。我们发现 PFD 症状在妊娠和产后 3 个月之间有显著差异（P<0.001）。PFDI-20 的所有成分均保持一致。此外，CRAD 症状的恢复更为明显与 SSL 的持续时间较短有关（P=0.03）。
在产后期间，PFD 症状有统计学意义上的恢复。此外，CRAD 症状的恢复程度更大与 SSL 的持续时间较短有关。
