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Pelvic organ support, symptoms and quality of life during pregnancy: a prospective study

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Abstract

Introduction and hypothesis

Prevalence studies show an increase in lower urinary tract and pelvic floor symptoms during pregnancy. The aim of our prospective study was to evaluate changes in pelvic organ support, pelvic floor symptoms and their effect on quality of life (QOL) during the first pregnancy using validated measures. We hypothesised that pregnancy is associated with worsening of pelvic floor function.

Methods

Objective assessment of pelvic organ support using the Pelvic Organ Prolapse Quantification (POP-Q) system and subjective evaluation of symptoms of pelvic floor disorders and related QOL with the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) were performed in the second trimester and then repeated at 36 weeks gestation.

Results

A total of 182 nulliparae attended the first visit at 20 weeks and 150 (82.4 %) women returned for follow-up at 36 weeks gestation. There were no significant changes in POP-Q points or stage between the two visits except for a significant increase in genital hiatus (p = 0.0001) and perineal body length (p = 0.0001). The vaginal symptoms did not show any changes. Symptoms and bother with voiding difficulties and stress urinary incontinence increased during pregnancy. Constipation (p = 0.02) and evacuation subdomains improved significantly (p = 0.009). In the sexual domain, the only subdomain that worsened significantly (p = 0.03) was “sex and vaginal symptoms”. None of the pelvic floor symptoms impacted the QOL.

Conclusions

In our group of nulliparae, pelvic floor-related QOL and prolapse stage did not change significantly from the second to the third trimester of pregnancy.

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Acknowledgements

We would like to thank all of the women who participated in the study. Ksenia Elenskaia and Inka Scheer were funded by the Mayday Childbirth Charity Fund. In addition, Ksenia Elenskaia received an unconditional educational grant from Johnson & Johnson.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Hospital of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Ksenia Elenskaia

  2. Department of Obstetrics and Gynaecology, Croydon University Hospital, 530 London Road, Croydon, CR7 7YE, UK

    Ksenia Elenskaia, Ranee Thakar, Abdul H. Sultan & Inka Scheer

  3. MVZ Gynaekologie, Aukammallee 33, 61595, Wiesbaden, Germany

    Inka Scheer

  4. Springfield Hospital, Lawn Lane, Chelmsford, CM1 7GU, UK

    Joseph Onwude

Authors
  1. Ksenia Elenskaia
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  2. Ranee Thakar
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  3. Abdul H. Sultan
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  4. Inka Scheer
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  5. Joseph Onwude
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Correspondence to Ranee Thakar.

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Elenskaia, K., Thakar, R., Sultan, A.H. et al. Pelvic organ support, symptoms and quality of life during pregnancy: a prospective study. Int Urogynecol J 24, 1085–1090 (2013). https://doi.org/10.1007/s00192-012-1935-4

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  • DOI: https://doi.org/10.1007/s00192-012-1935-4

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