Badiu Diana, Onuc Silvia, Niculescu Costin, Delcea Cristian, Tica Vlad
Obstetrics and Gynecology Department, University Emergency County Hospital Constanta, Constanta, Romania.
Faculty of Medicine, Ovidius University from Constanta, Constanta, Romania.
Medicine (Baltimore). 2025 Jul 25;104(30):e43554. doi: 10.1097/MD.0000000000043554.
Before undertaking any future interventions targeted at preventing pelvic organ prolapse (POP) after vaginal birth, a great depth of understanding of the condition is required. The aim of the paper is to explore postpartum women treatment perspective on POP. The study employed a qualitative descriptive design which involved 12 postpartum women with stages II and III of POP, after vaginal birth in our University Hospital from Constanta, Romania. Age, body mass index, education, parity, comorbidities, previous surgical interventions, and smoking status were evaluated. Each woman was given a semi-structured interview from April to September 2024 immediately and at 6-months after vaginal birth, during which their perspectives on different POP treatment were explored. The interviews were audio-recorded, transcribed verbatim and analyzed using content analysis. The mean age was 29.05 years (range 18-38 years). Most women had a body mass index <30 (66.66%), and 58.33% had a high school as education. There were 58.33% (n = 7) postpartum women with stage II POP with vaginal births without episiotomy and 41.66% on stage III POP (i.e., 4 women with vaginal birth and episiotomy and 1 woman at the 5th vaginal birth only). Four dominant themes emerged immediately after vaginal birth: speeding up the treatment decision for POP by symptomatology; friends and, less frequently, family or Internet, as influencing factors in the choice of treatments for POP; the perspective of a conservative treatment; supervised pelvic floor muscle training and other conservative treatment as the best choice in postpartum. Two themes emerged at 6-months after vaginal birth: desire of un-delaying the treatment, even in case of feeling improved POP symptoms at 6-months postpartum; and the choice of a simple treatment at 6-months, aiming the increasing quality of life. The preference into conservative treatment of postpartum women with POP, supervised pelvic floor muscle training most often indicated among them, could contribute to implement relevant adapted strategies in a field that need more research.
在开展任何旨在预防阴道分娩后盆腔器官脱垂(POP)的未来干预措施之前,需要对该病症有深入的了解。本文的目的是探讨产后女性对盆腔器官脱垂的治疗观点。该研究采用定性描述性设计,涉及罗马尼亚康斯坦察市我校医院12名阴道分娩后患有II期和III期盆腔器官脱垂的产后女性。评估了年龄、体重指数、教育程度、产次、合并症、既往手术干预情况和吸烟状况。每位女性在2024年4月至9月期间,于阴道分娩后立即及产后6个月接受了半结构化访谈,期间探讨了她们对不同盆腔器官脱垂治疗方法的观点。访谈进行了录音,逐字转录并采用内容分析法进行分析。平均年龄为29.05岁(范围18 - 38岁)。大多数女性体重指数<30(66.66%),58.33%的女性接受的是高中教育。58.33%(n = 7)的产后女性为II期盆腔器官脱垂且阴道分娩未行会阴切开术,41.66%为III期盆腔器官脱垂(即4名阴道分娩并会阴切开术的女性和1名仅第5次阴道分娩的女性)。阴道分娩后立即出现了四个主要主题:根据症状加快盆腔器官脱垂治疗决策;朋友以及较少情况下家人或互联网,作为盆腔器官脱垂治疗选择的影响因素;保守治疗的观点;监督下的盆底肌肉训练和其他保守治疗作为产后的最佳选择。阴道分娩后6个月出现了两个主题:即使产后6个月感觉盆腔器官脱垂症状有所改善,仍希望不延迟治疗;产后6个月选择简单治疗方法,旨在提高生活质量。产后盆腔器官脱垂女性对保守治疗的偏好,其中最常提到的是监督下的盆底肌肉训练,这可能有助于在一个需要更多研究的领域实施相关的适应性策略。