Fertel Simone R, Clare Alyssa, Tanner Jean P, Propst Katie
Urogynecology and Reconstructive Pelvic Surgery, USF (University of South Florida) Health, Tampa, USA.
Medicine, University of South Florida, Tampa, USA.
Cureus. 2024 Jul 24;16(7):e65307. doi: 10.7759/cureus.65307. eCollection 2024 Jul.
Objectives This study assesses the screen rate and prevalence of postpartum pelvic floor disorders and sexual dysfunction (PFDs/SD) within the first year of delivery. Methods This is a retrospective review of postpartum women seen in a university clinic who delivered at the associated hospital and had postpartum visits from June 1, 2020, to April 15, 2022. Charts were reviewed from delivery to one year postpartum. Demographic and clinical characteristics were compared between women with and without postpartum screening. Results Three hundred thirty-four women met inclusion criteria. Two hundred twenty (65.9%) were screened for PFDs/SD. Compared to women who were not screened, women who were screened were older (32.6 vs 31.3 years, p=0.02). Women with a cesarean delivery (73% vs. 58% vaginal, p=0.004), delivered by an attending or resident (70% vs 60% midwife, p=0.06), first postpartum visit at less than six weeks after delivery (76% vs. 43% 6-12 weeks, p<0.001), and three or more postpartum visits (80% vs. 65% two visits, 50% one visit, p<0.001) were more likely to be screened. In an adjusted model, only timing of the first postpartum visit remained significant. Urinary incontinence and fecal incontinence were the most common PFDs diagnosed. Of the 41 women who had PFDs and/or SD, 31 (75.6%) were referred to pelvic floor physical therapy (PFPT) and/or urogynecology. Discussion In this retrospective cohort study, we found a low rate of postpartum screening for PFDs/SDs. This deficiency highlights critical gaps in care for postpartum women.
目的 本研究评估分娩后第一年内产后盆底功能障碍和性功能障碍（PFDs/SD）的筛查率和患病率。方法 这是一项对在大学诊所就诊的产后妇女的回顾性研究，这些妇女在相关医院分娩，并于2020年6月1日至2022年4月15日进行了产后随访。对从分娩到产后一年的病历进行了回顾。比较了接受和未接受产后筛查的妇女的人口统计学和临床特征。结果 334名妇女符合纳入标准。220名（65.9%）接受了PFDs/SD筛查。与未接受筛查的妇女相比，接受筛查的妇女年龄更大（32.6岁对31.3岁，p = 0.02）。剖宫产的妇女（73%对阴道分娩的58%，p = 0.004）、由主治医生或住院医生接生的妇女（70%对助产士接生的60%，p = 0.06）、产后首次就诊时间在分娩后不到六周的妇女（76%对6 - 12周的43%，p < 0.001）以及产后就诊三次或更多次的妇女（80%对两次就诊的65%、一次就诊的50%，p < 0.001）更有可能接受筛查。在调整模型中，只有产后首次就诊时间仍然具有统计学意义。尿失禁和粪失禁是最常见的被诊断出的PFDs。在41名患有PFDs和/或SD的妇女中，31名（75.6%）被转诊至盆底物理治疗（PFPT）和/或妇科泌尿学。讨论 在这项回顾性队列研究中，我们发现产后PFDs/SDs的筛查率较低。这一不足凸显了产后妇女护理方面的关键差距。
