1
|
Brunelli WS, Caroci Becker A, Lima MOP, Oliveira SG, Ochiai AM, Caroci L, Araújo NMD, Riesco ML. Repercussions of perineal repair using surgical glue or suture thread on postpartum outcomes: A controlled randomized clinical trial in São Paulo, Brazil. Eur J Midwifery 2024; 8:EJM-8-46. [PMID: 39185251 PMCID: PMC11342807 DOI: 10.18332/ejm/191248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth. METHODS A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out. RESULTS A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH2O and 27.4 cmH2O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance. CONCLUSIONS Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.
Collapse
Affiliation(s)
- Wesllanny S Brunelli
- Maternal and Child Department, School of Nursing, São Paulo University, São Paulo, Brazil
| | - Adriana Caroci Becker
- Maternal and Child Department, School of Nursing, São Paulo University, São Paulo, Brazil
- Midwifery Department, School of Arts, Sciences and Humanities, São Paulo University, São Paulo, Brazil
| | - Marlise O P Lima
- Midwifery Department, School of Arts, Sciences and Humanities, São Paulo University, São Paulo, Brazil
| | | | - Angela M Ochiai
- Midwifery Department, School of Arts, Sciences and Humanities, São Paulo University, São Paulo, Brazil
| | - Lucca Caroci
- Healthcare Management Program, St. Francis College, New York, United States
| | - Natalucia M D Araújo
- Midwifery Department, School of Arts, Sciences and Humanities, São Paulo University, São Paulo, Brazil
| | - Maria L Riesco
- Maternal and Child Department, School of Nursing, São Paulo University, São Paulo, Brazil
| |
Collapse
|
2
|
Govahi M, Behmanesh F, Gholinia H, Omidvar S, Adib-Rad H. Health-promoting lifestyle in mothers with vaginal childbirth and cesarean section in the postpartum period. BMC Womens Health 2024; 24:146. [PMID: 38409091 PMCID: PMC10898097 DOI: 10.1186/s12905-024-02984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND In the postpartum period, there are numerous changes in the physical and psychological dimensions of women, which reduce the quality of life of women. The aim of this study was to compare the health-promoting lifestyle of mothers with vaginal delivery and cesarean delivery in the postpartum period. METHODS This cross-sectional study was conducted on 77 pregnant women who had delivered vaginal or by cesarean section at Shohadaye Behshahr Hospital and were selected based on inclusion criteria. If the women were willing to participate in the study, a demographic questionnaire was completed, and the telephone numbers of the subjects were recorded so that the Porsline health-promoting lifestyle questionnaire could be sent to them. Data were analyzed with SPSS 22 using the T test, chi-square test and Repeated Measure ANOVA. RESULTS There was no difference in the average score of health-promoting lifestyle and its dimensions between the two groups of vaginal delivery and cesarean section at two and six weeks after delivery. However, in both groups, the total score of health-promoting lifestyle decreased significantly over time (P < 0.001). CONCLUSIONS There was no difference in health-promoting lifestyle between mothers with vaginal and mothers with cesarean delivery at two weeks and six weeks after delivery. This requires more attention from policy makers to make vaginal childbirth more convenient, and by reducing complications after vaginal childbirth, they can improve women's healthy lifestyles and, in turn, families. Also, it seems that the other variables apart from the method of delivery should be considered, and it is necessary to distinguish these variables such as routine episiotomy in order to prevent the decrease in the level of health-promoting behaviors among women during puerperium period.
Collapse
Affiliation(s)
- Motahareh Govahi
- Student Research Committee, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Fereshteh Behmanesh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran.
| | - Hemmat Gholinia
- Health research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Hajar Adib-Rad
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| |
Collapse
|
3
|
Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, Peters LL. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5252. [PMID: 37047868 PMCID: PMC10094321 DOI: 10.3390/ijerph20075252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.
Collapse
Affiliation(s)
- Anne-Marie Fanshawe
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Ank De Jonge
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Nicole Ginter
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, 128 08 Prague, Czech Republic
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Morris A. Swertz
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lilian L. Peters
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| |
Collapse
|
4
|
Gould J, Webb SS, Byrne C, Brace E, Cleary J, Dow L, Edwards E, Glyn-Jones E, Hunter T, Longton J, Tibble K, MacLellan J. Red flags for episiotomy in a midwife-led birth: Using co-production with midwives to capture clinical experience. Women Birth 2023; 36:217-223. [PMID: 35941059 DOI: 10.1016/j.wombi.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND One of four key points in the Obstetric Anal Sphincter Injury Care Bundle, first piloted in the UK in 2016, was the directive to perform episiotomy when clinically indicated. Midwives are the primary health care professional for straightforward births in the UK and there is very little published literature that relates to their practice in this area. AIM The aim of the study was to explore experienced midwives' decision-making processes in their assessments for episiotomy during birth. METHODS 43 midwives self-identifying as confident in performing episiotomy were sampled across 8 NHS Trusts in England and Wales. Data collection was via online focus groups and 1:1 interviews. Primary thematic analysis was undertaken by the research team. Preliminary themes were used to structure a co-production analysis workshop where eight experienced midwives undertook a secondary analysis of the data resulting in four overall themes. FINDINGS Four themes were identified, 'Optimising Perineal Function', 'Red Flags to Stimulate Decision-Making', 'The Midwives' Episiotomy' and 'Infiltration as a Catalyst for Birth'. DISCUSSION Midwives use a number of visual, auditory and touch cues to inform their assessments for episiotomy during birth. CONCLUSION This study provides valuable insight into the cues that guide experienced midwives' decision-making in relation to episiotomy and contributes evidence related to performing episiotomy when clinically indicated in spontaneous vaginal birth.
Collapse
Affiliation(s)
| | | | - Carmen Byrne
- Freelance visual artist and researcher (narrative specialist)
| | | | - Jane Cleary
- University Hospitals Sussex NHS Foundation Trust, UK
| | | | | | | | | | | | - Katie Tibble
- University Hospitals Sussex NHS Foundation Trust, UK
| | | |
Collapse
|
5
|
Wannarit LO. Sexual abstinence as a reproductive health-promoting behavior for women: A perspective. BELITUNG NURSING JOURNAL 2022; 8:372-377. [PMID: 37546502 PMCID: PMC10401362 DOI: 10.33546/bnj.2155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/26/2022] [Accepted: 07/22/2022] [Indexed: 08/08/2023] Open
Abstract
This article is intended to provide an appropriate context for adopting sexual abstinence from a health-promoting behavioral perspective that can be applied to women of reproductive age worldwide to improve reproductive health, maintain well-being, and prevent health problems in women. The topics related to women's health status, sexual abstinence definitions, benefits, and application, as well as sexual autonomy and efficacy, including family collaboration, are discussed. This article will provide health care providers, especially nurses and midwives, with new ideas for integrating sexual abstinence into nursing and midwifery practice.
Collapse
|
6
|
Hidalgo-Lopezosa P, Pérez-Marín S, Jiménez-Ruz A, López-Carrasco JDLC, Cubero-Luna AM, García-Fernández R, Rodríguez-Borrego MA, Liébana-Presa C, López-Soto PJ. Factors Associated with Postpartum Sexual Dysfunction in Spanish Women: A Cross-Sectional Study. J Pers Med 2022; 12:jpm12060926. [PMID: 35743712 PMCID: PMC9225642 DOI: 10.3390/jpm12060926] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 12/01/2022] Open
Abstract
(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out in three primary care centers in southern Spain, with women in the postpartum period who had a single low-risk birth. One hundred and seventeen women answered the Female Sexual Function questionnaire during the 4th month postpartum, between January 2020 and December 2021. Sociodemographic, obstetric, neonatal variables and level of self-esteem were analyzed. A multiple logistic regression model was carried out; (3) Results: 78.4% had high level of self-esteem. FSD prevalence was 89.7%. Factors related to FSD were having an instrumental vaginal delivery, women with university studies, and prenatal preparation. Maternal age ≥ 35, multiparity, pathological processes in the child, a medium–low level of self-esteem and newborn weight were associated with disorders in some of domains of sexual function; (4) Conclusions: FSD is highly prevalent in the postpartum period and is associated with preventable factors. A preventive approach by health professionals to these factors is essential. Health services should implement postpartum follow-up programs, which may coincide in time and place with newborn follow-up programs.
Collapse
Affiliation(s)
- Pedro Hidalgo-Lopezosa
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
- Correspondence: ; Tel.: +34-957-218-107
| | - Sandra Pérez-Marín
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
| | - Andrea Jiménez-Ruz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Juan de la Cruz López-Carrasco
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Ana María Cubero-Luna
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Rubén García-Fernández
- SALBIS Research Group, Departamento de Enfermería y Fisioterapia, Universidad de León, Campus de Ponferrada s/n, 24400 Ponferrada, Spain; (R.G.-F.); (C.L.-P.)
| | - María Aurora Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Cristina Liébana-Presa
- SALBIS Research Group, Departamento de Enfermería y Fisioterapia, Universidad de León, Campus de Ponferrada s/n, 24400 Ponferrada, Spain; (R.G.-F.); (C.L.-P.)
| | - Pablo Jesús López-Soto
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| |
Collapse
|
7
|
Moser ADDL, Nogueira NDV, Thomé BI, Paz LP. Prevalence of urinary incontinence subtypes in women. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Urinary incontinence (UI) is present in the lives of a considerable number of women worldwide. This condition and its associated factors have been sufficiently investigated in recent years, however, prevalence estimates are still not fully clarified, as UI is seen as stigmatizing in a cultural context, and the search for treatment is not always considered by affected individuals. So, this dysfunction and its subtypes must be better understood so that it is possible to alleviate its consequences. Objective: To identify the prevalence of urinary incontinence subtypes, in women from a reference clinic in a public hospital in Curitiba, PR, Brazil. Methods: This was an observational and analytical study, with 227 women affected by UI, evaluated by means of a questionnaire including sociodemographic and general health information, in addition to defining the UI subtype. The SPSS version 25 was used for statistical analysis. Results: The patients presented a mean age of 60.33 ± 12.26 years. Mixed UI was the prevalent subtype (87.2%; n = 198), followed by stress (7.5%; n = 17), and urge (5.3%; n = 12). Among women with mixed UI, 60.6% had only completed elementary school, 59.1% were housewives, and 87.6% had experienced two or more pregnancies. Conclusion: Outlining UI subtypes, and the general and obstetric characteristics of the studied population enables the development of coping strategies for this condition, ranging from planning, diagnosis and treatment, to costs and public health management.
Collapse
|
8
|
Moser ADDL, Nogueira NDV, Thomé BI, Paz LP. Prevalência dos subtipos de incontinência urinária em mulheres. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356012.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução: A incontinência urinária (IU) está presente na vida de considerável número de mulheres no mundo. Essa condição e fatores associados a ela vêm sendo suficientemente investigados nos últimos anos, no entanto, as estimativas de prevalência ainda não são totalmente esclarecidas visto que a IU é vista como estigmatizante em âmbito cultural e a procura por tratamento nem sempre é considerada por indivíduos acometidos. Torna-se importante, portanto, esclarecer cada vez mais essa disfunção e seus subtipos para que seja possível amenizar suas consequências. Objetivo: Identificar a prevalência dos subtipos de IU em mulheres de um ambulatório de referência em um hospital público de Curitiba, PR. Métodos: Estudo observacional e analítico com 227 mulheres com IU, avaliadas por meio de um questionário para coleta de informações sociodemográficas e de saúde geral, além da definição do subtipo de IU. Utilizou-se o pacote estatístico SPSS versão 25 para a análise estatística. Resultados: A idade média da amostra foi de 60,33 ± 12,26 anos. IU mista foi o subtipo mais prevalente (87,2%; n = 198), seguida por esforço (7,5%; n = 17) e urgência (5,3%; n = 12). Das mulheres com IU mista, 60,6% tinham apenas o ensino fundamental, 59,1% eram donas de casa e 89,4% passaram por duas ou mais gestações. Conclusão: Delinear os subtipos de IU e as características gerais e obstétricas da população estudada permite que sejam elaboradas estratégias de enfrentamento desta condição, que vão desde planejamento envolvendo diagnóstico e tratamento até custos e gestão de saúde pública.
Collapse
|
9
|
Cattani L, De Maeyer L, Verbakel JY, Bosteels J, Deprest J. Predictors for sexual dysfunction in the first year postpartum: a systematic review and meta-analysis. BJOG 2021; 129:1017-1028. [PMID: 34536325 DOI: 10.1111/1471-0528.16934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnancy and childbirth increase the risk for pelvic floor dysfunction, including sexual dysfunction. So far, the mechanisms and the extent to which certain risk factors play a role remain unclear. OBJECTIVES In this systematic review of the literature we aimed to determine risk factors for sexual dysfunction in the first year after childbirth. SEARCH STRATEGY We searched MEDLINE, Embase and CENTRAL using the search strategy: sexual dysfunction AND obstetric events. SELECTION CRITERIA We included original, comparative studies, reported in English, that used validated questionnaires and the ICS/IUGA terminology for sexual dysfunction, dyspareunia and vaginal dryness. DATA COLLECTION AND ANALYSIS We assessed the quality and the risk of bias of the included studies with the Newcastle-Ottawa scale. We extracted the reported data and we performed random-effects meta-analysis to obtain the summary odds ratios (ORs) with 95% confidence intervals (95% CIs). Heterogeneity across studies was assessed using the I2 statistic. MAIN RESULTS Anal sphincter injury was associated with increased odds for both sexual dysfunction (OR 3.00, 95%CI 1.28-7.03) and dyspareunia (OR 1.92, 95% CI 1.47-2.52). Episiotomy was associated with dyspareunia (OR 1.64, 95% CI 1.25-2.14), but not with sexual dysfunction (OR 1.90, 95% CI 0.94-3.84). Compared with spontaneous birth, caesarean section reduced the odds for dyspareunia (OR 0.68, 95% CI 0.54-0.86) but not for sexual dysfunction (OR 1.14, 95% CI 0.89-1.46). Instrumental vaginal birth increased the odds for sexual dysfunction (OR 1.70, 95% CI 1.05-2.76), yet no difference was found for dyspareunia (OR 1.82, 95% CI 0.88-3.75). One study of low quality reported on vaginal dryness and found no association with obstetric events. CONCLUSIONS Perineal trauma, rather than mode of birth, increases the odds for sexual dysfunction in the first year after childbirth. TWEETABLE ABSTRACT Perineal trauma, rather than mode of birth, correlates with sexual dysfunction and dyspareunia postpartum. #dyspareunia #OASI #episiotomy.
Collapse
Affiliation(s)
- L Cattani
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - L De Maeyer
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - J Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - J Bosteels
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, Belgium
| | - J Deprest
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Research Department of Maternal Fetal Medicine, Institute for Women's Health, University College London, London, UK
| |
Collapse
|
10
|
Taleb S, Saeedi M. The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial. BMC Complement Med Ther 2021; 21:166. [PMID: 34103042 PMCID: PMC8186151 DOI: 10.1186/s12906-021-03339-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 02/05/2023] Open
Abstract
Background The pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing. Methods The study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention. Results Before the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01). Conclusions According to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process. Trial registration This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT201404073106N15” on 02/12/2015.
Collapse
Affiliation(s)
- Sahar Taleb
- Saveh University of Medical Sciences, Saveh, Iran
| | | |
Collapse
|
11
|
de Sousa NQ, Borges AC, Sarabando R, Bivar L, Viana J, Cerqueira M, Miranda A, Reis I, Nogueira-Silva C. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021; 18:1075-1082. [PMID: 37057472 DOI: 10.1016/j.jsxm.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/22/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Childbirth brings many changes to women's life and sexual health. The influence of operative vaginal delivery on sexual function has produced inconsistent results. AIM To evaluate the effects of mode of vaginal delivery (spontaneous or operative) in postpartum sexual function. METHODS Descriptive prospective study (MOODS- Maternal-neonatal Outcomes in Operative Vaginal Delivery) including 304 women who had a singleton term vaginal delivery (operative or spontaneous in a relation 2:1). Women were invited to answer a questionnaire at 3, 6 months and 1 year postpartum. OUTCOMES MEASUREMENT A validated questionnaire was applied, the Female Sexual Function Index (FSFI) Score, to evaluate effects of operative delivery on sexual health. Sexual dysfunction was defined by FSFI score <26.55. RESULTS 211 women answered at least one questionnaire. Overall rate of sexual dysfunction was 62%, 43% and 48% at 3, 6 and 12 months respectively. At 3 months, total FSFI score was significantly lower in operative vaginal delivery group (mean±SD, 21.3±8.6 vs 24.9±7.9, P = 0.015). Arousal (P = 0.028), orgasm (P = 0.029), satisfaction (P = 0.015) and pain (P = 0.007) FSFI domains were also significantly inferior. At this time, 44% women in spontaneous delivery group and 70% in operative delivery group had sexual dysfunction (P = 0.0002). At 6 months, there were no differences in FSFI scores according the type of delivery. At 12 months, total FSFI score was similar in both groups, but pain domain was significantly lower in operative delivery (P = 0.004). Considering type of instrument (Thierry's Spatulas or Kiwi Vacuum), no differences were found regarding episiotomy, perineal trauma, obstetric anal sphincter injury or postpartum complications. FSFI scores did not differ between the two instruments at any time point. A logistic regression showed that, when controlled for perineal trauma, mode of delivery was independently associated with sexual dysfunction at 3 months (P = 0.02). CLINICAL IMPLICATIONS Clinicians should assess women's sexual health during pregnancy and postpartum period in order to enhance their wellbeing. STRENGTHS/LIMITATIONS Strengths include its prospective design, standardized questionnaire and the new perspectives about a different obstetrical instrument (Thierry's spatulas). Limitations include the absence of pre-pregnancy sexual function data and considerable drop-out rate. CONCLUSION Sexual dysfunction affects a great proportion of newly mothers and in postpartum period mode of delivery and perineal trauma seem to play an important role. Although there was a progressive reduction over time, prevalence of sexual dysfunction at 6 months and 1 year postpartum was still considerable. The type of obstetrical instrument does not seem to influence short or long-term sexual function. de Sousa NQ, Borges AC, Sarabando R, et al. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021;18:1075-1082.
Collapse
Affiliation(s)
| | | | - Rita Sarabando
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Leonor Bivar
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Johanna Viana
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Margarida Cerqueira
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra Miranda
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Isabel Reis
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Cristina Nogueira-Silva
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
12
|
Yang J, Bai H. Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: a cross-sectional study from China. BMJ Open 2021; 11:e043596. [PMID: 33846148 PMCID: PMC8047989 DOI: 10.1136/bmjopen-2020-043596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Episiotomy is still performed widely by obstetricians and midwives in some Chinese maternity units, but the reasons are unknown. This study aims to determine the knowledge, attitude and experience towards the practice of episiotomy among obstetricians and midwives in China's public hospitals and consider strategies to reduce its practice. METHODS A cross-sectional web survey using a self-administered questionnaire was conducted among obstetricians and midwives in 90 public hospitals in Henan Province, China. RESULTS 900 (82.21%) participants completed the questionnaire. Average knowledge level (4.15, SD=1.10) on complications and overuse was identified among participants. Episiotomy was performed more frequently in secondary hospitals than in tertiary hospitals (p<0.05). Senior clinicians were more likely to perform episiotomy than younger ones (p<0.05). Almost half of the clinicians (42.11%) considered the current rate of episiotomy (45%) to be right or too low. The most common reason for performing episiotomy identified by obstetricians (83.94%) and midwives (79.69%) was to reduce third-degree or fourth-degree perineal laceration. Both obstetricians (80.29%) and midwives (82.57%) agreed that the most significant obstacle to reducing the rate of episiotomy was lack of training on reducing perineal tears. CONCLUSION In sum, episiotomy was driven by previous training, practitioners' experience and local norms rather than the latest medical evidence. Clinicians in secondary hospitals and senior clinicians are key training targets. It is urgent to improve current clinical policies and surgical procedure guidelines for obstetricians and midwives regarding episiotomy.
Collapse
Affiliation(s)
- Jingxuan Yang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Hua Bai
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
13
|
Dağli E, Kul Uçtu A, Özerdoğan N. Sexual dysfunction in the postpartum period: Its relationship with postpartum depression and certain other factors. Perspect Psychiatr Care 2021; 57:604-609. [PMID: 32677049 DOI: 10.1111/ppc.12583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/04/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study aimed to determine the prevalence of female sexual dysfunction in the postpartum period and its relationship with postpartum depression and certain other factors. DESIGN AND METHODS Data were collected using an information form, the female sexual function index (FSFI), and the Edinburgh postpartum depression scale (EPDS) (N = 123). FINDINGS A negative, very high, and statistically significant relationship was found between FSFI and EPDS scores (r = -0.831; P = .000). PRACTICE IMPLICATIONS The frequency of sexual dysfunction may increase in women at risk of postpartum depression.
Collapse
Affiliation(s)
- Elif Dağli
- Health Care Services Department, Abdi Sütcü Vocational School of Health Services, Çukurova University, Adana, Turkey
| | - Arzu Kul Uçtu
- Midwifery Department, Health School, Bozok University, Yozgat, Turkey
| | - Nebahat Özerdoğan
- Midwifery Department, Faculty of Health Sciences, Eskişehir Osmangazi University, Eskişehir, Turkey
| |
Collapse
|
14
|
Sheikhi ZP, Navidian A, Rigi M. Effect of sexual health education on sexual function and resumption of sexual intercourse after childbirth in primiparous women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:87. [PMID: 32509895 PMCID: PMC7271915 DOI: 10.4103/jehp.jehp_591_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/13/2019] [Indexed: 05/17/2023]
Abstract
INTRODUCTION A large number of women experience sexual health problems during the postpartum period. This study aimed to evaluate the effect of sexual health education on sexual function and time of sexual intercourse resumption after childbirth in primiparous women in Southeast Iran. MATERIALS AND METHODS This randomized clinical trial was conducted on 94 primiparous women randomly divided into two groups of intervention and control. The intervention group was subjected to three training sessions 3-5, 10-14, and 30-45 days after childbirth (first session lasting 20 min and other sessions 60 min). On the other hand, the participants in the control group only received the routine postpartum training. The Female Sexual Function Index (FSFI) was completed by all participants before and 8 weeks after the intervention. Data were analyzed in SPSS software (version 22) using descriptive and inferential statistics, such as Chi-square test, independent t-test, and paired sample t-test. P < 0.05 was considered statistically significant. RESULTS The mean score of FSFI in the intervention group was increased from 12.70 ± 6.166 before the onset of the intervention to 17.36 ± 5.407 after 8 weeks (P = 0.01). In the control group, the mean score of FSFI was decreased from 13.09 ± 4.306 to 12.29 ± 3.511 on the 8th week postpartum (P = 0.06). The mean times of sexual intercourse resumption in the intervention and control groups were 5.82 ± 0.17 and 5.81 ± 0.22 weeks, respectively, which were not significantly different between the two groups (P = 0.879). CONCLUSION Sexual health education for women in the postpartum period could improve their sexual function after childbirth. However, it is recommended to use sexual health education programs in women during the postpartum period to promote female sexual function.
Collapse
Affiliation(s)
- Zahra Pahlavani Sheikhi
- Pregnancy Health Research Center, Zahedan University of Medical Science, Department of Counseling Midwifery, Nursing and Midwifery School, Zahedan University of Medical Science, Zahedan, Iran
| | - Ali Navidian
- Pregnancy Health Research Center, Zahedan University of Medical Science, Department of Counseling Midwifery, Nursing and Midwifery School, Zahedan University of Medical Science, Zahedan, Iran
| | - Mahnaz Rigi
- Student of Midwifery Counseling, School of Nursing and Midwifery Zahedan University of Medical Science, Zahedan, Iran
| |
Collapse
|