In this study of patients with the same ethnicity, the better survival outcome in latter (Group 2) patients suggests improvement of treatment, especially for patients with more advanced and metastatic cancer (stage IV).

INTRODUCTION: Study purpose is to examine safety and feasibility of a novel pelvic floor dilator used during active labor to reduce pelvic floor injury. METHODS:Pilot study evaluating performance of novel semiautomated pelvic floor dilator (Materna Medical, San Francisco). Inclusion criteria were healthy primiparas, singletons, cephalic presentation and planned epidural. At 36 weeks gestation and 12 weeks postpartum, pelvic examination was done by urogynecologist blinded to patient's course. During active labor, device was inserted in vaginal introitus to achieve preset pelvic floor dilation of 8 cm over 30-60 minute. Primary outcome was rate of lacerations, superficial skin bleeding, skin abrasion or need for surgical repair. Secondary outcomes were pelvic floor disruption diagnosed clinically, mode of delivery, and perineal lacerations (rate and degree).