Predicting risk of pelvic floor disorders 12 and 20 years after delivery

Jelovsek, J. Eric; Chagin, Kevin; Gyhagen, Maria; Hagen, Suzanne; Wilson, Don; Kattan, Michael W.; Elders, Andrew; Barber, Matthew D.; Areskoug, Björn; MacArthur, Christine; Milsom, Ian

doi:10.1016/j.ajog.2017.10.014

Cited by 74 publications

(57 citation statements)

References 27 publications

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“…Among them are biomechanical conditions of the critical structures along the birth canal (perineum and levator ani), fetal size, and bony pelvis size. Several models based on the physical features of the mother and the fetus have been developed to assess the risk of pelvic floor trauma and long-term risk of childbirth complications [6][7][8]. Nevertheless, these models do not include an important variable, i.e., perineal elasticity and its reversible distensibility from the pubic symphysis.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of antepartum tactile imaging

et al. 2020

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Introduction and hypothesis Quantitative characterization of the birth canal and critical structures before delivery may provide risk assessment for maternal birth injury. The objective of this study was to explore imaging capability of an antepartum tactile imaging (ATI) probe. Methods Twenty randomly selected women older than 21 years with completed 35th week of pregnancy and a premise of vaginal delivery were enrolled in the feasibility study. The biomechanical data were acquired using the ATI probe with a double-curved surface, shaped according to the fetal skull and equipped with 168 tactile sensors and an electromagnetic motion tracking sensor. Software package COMSOL Multiphysics was used for finite element modeling. Subjects were asked for assessment of pain and comfort levels experienced during the ATI examination. Results All 20 nulliparous women were successfully examined with the ATI. Mean age was 27.8 ± 4.1 years, BMI 30.7 ± 5.8, and week of pregnancy 38.8 ± 1.4. Biomechanical mapping with the ATI allowed real-time observation of the probe location, applied load to the vaginal walls, and a 3D tactile image composition. The nonlinear finite element model describing the stress–strain relationship of the pelvic tissue was developed and used for calculation of Young’s modulus (E). Average perineal elastic modulus was 11.1 ± 4.3 kPa, levator ani 4.8 ± 2.4 kPa, and symphysis–perineum distance was 30.1 ± 6.9 mm. The pain assessment level for the ATI examination was 2.1 ± 0.8 (scale 1–4); the comfort level was 2.05 ± 0.69 (scale 1–3). Conclusions The antepartum examination with the ATI probe allowed measurement of the tissue elasticity and anatomical distances. The pain level was low and the comfort level was comparable with manual palpation.

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Section: Introductionmentioning

confidence: 99%

Feasibility and safety of antepartum tactile imaging

et al. 2020

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“…This enables counseling regarding the most appropriate mode of delivery. Jelovsek et al (2018) published risk of postnatal symptoms algorithm, 12 and 20 years after delivery which has a 51% to 74% chance of predicting LUTS correctly.…”

Section: Methodsmentioning

confidence: 99%

Recommendations and future research initiative to optimize bladder management in pregnancy and childbirth International Consultation on Incontinence ‐ Research society 2018

Rantell

Veit‐Rubin

Giarenis

et al. 2019

Neurourology and Urodynamics

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With increasing birth rates globally, obstetric bladder care and long term pelvic floor dysfunction continues to be a issue. This paper aims to provide an overview of the concerns in the antenatal, intrapartum an post partum periods and presents recommendation for the research requirements necessary and education to challenge current practice. K E Y W O R D Sbladder care, catheterization, intrapartum, obstetric bladder management, postpartum

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“…They must be informed that vaginal delivery is not “harmlessly natural”. When compared with C‐Section, it is associated with a higher risk of pelvic organ prolapse perineal tears and fecal incontinence; and that there is a 5.2 odds ratio of developing these three types of pelvic floor dysfunction combined; that C‐Section has a protective effect, especially in women with high body mass index, less than 160 cm of height or more than 40 years of age and/or when fetuses weight ≥4 kg . They should also be informed that the available treatment of these conditions is not very effective and often multiple surgical interventions are required .…”

Section: The Motion In Support Of Cesarean Deliverymentioning

confidence: 99%

ICS debate article—childbirth, modes of delivery, and pelvic floor dysfunction—challenges in educating women about modes of delivery and granting an informed decision process

Lemos

Doumouchtsis

2019

Neurourology and Urodynamics

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The impact of the mode of birth on the mother and fetus has been a popular topic for a long‐standing debate. Several morbidities have been associated with one mode of delivery or another. When this debate focuses specifically on the effects of vaginal birth or cesarean delivery on pelvic floor function and dysfunction, current research‐based evidence fails to provide clear answers as many contributing and confounding factors, and other limitations inherent to the evidence itself blur the links between causes and outcomes. This debate article provides and overview of the biopsychosocial gaps on this subject and raises questions to the current state in patient counselling on labour and delivery.

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Predicting risk of pelvic floor disorders 12 and 20 years after delivery

Cited by 74 publications

References 27 publications

Feasibility and safety of antepartum tactile imaging

Feasibility and safety of antepartum tactile imaging

Recommendations and future research initiative to optimize bladder management in pregnancy and childbirth International Consultation on Incontinence ‐ Research society 2018

ICS debate article—childbirth, modes of delivery, and pelvic floor dysfunction—challenges in educating women about modes of delivery and granting an informed decision process

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