Perineal Injury and Its Association with Postpartum Sexual Dysfunction among First Delivery Women (original) (raw)
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Open Access Macedonian Journal of Medical Sciences
BACKGROUND: Various anatomical and physiological changes occur to provide a suitable environment for fetal development during pregnancy. Changes in body shape and other physical changes also undergo changes and are associated with postpartum sexual dysfunction. AIM: This study aims to measure and determine the difference in female sexual function index scores for primiparous women post normal delivery and post-cesarean section. METHODS: An observational analytic study with a cross-sectional study design conducted in a hospital. This study involved 60 women with inclusion criteria aged 20–35 years, primiparous women with post-term pregnancy, primiparous women after normal delivery and cesarean section at 3–4 months, women who were married and living with their husbands and were willing to participate in this study. Data were analyzed descriptively and statistically. RESULTS: The results showed that the cause of perineal damage was mostly due to the mediolateral episiotomy, the degree...
Journal of Health, Medicine and Nursing, 2019
Perineal trauma is classified according to the degree of structures involved or according to the depth of the injury. Mild perineal trauma is very common following vaginal delivery. Risk factors for perineal trauma include primiparity, precipitate labour, instrumental deliveries, pushing techniques and birth positions. Perineal trauma is associated with significant short-term and long-term complications. The objective of the study was to determine the prevalence and risk factors for perineal trauma among women at teaching and referral hospital in western Kenya. A cross-sectional study was carried out at the teaching hospital between April and May 2015. Two hundred and nine women who had come to deliver at the facility were consented to participate in the study. A structured checklist was used to obtain data from the women and make observations as skilled care givers attended to deliveries. All analyses were performed at 95% level of confidence. Two hundred and nine (209) deliveries were observed. Majority of the women, 76 (36.40%), were in the 20-24 age group. Ninety seven (46.10%) of them were para 0. Eighty one (38.8%) of the women sustained various types of perineal trauma. Supine position during delivery was the most preferred position, in 201 (96.2%), of the women. Age of the mother, parity, infant birth weight, and history of previous trauma, were statistically significant, associated with trauma in the univariate analysis (p=0.013; p=0.000; p= 0.010; p= 0.033) respectively. Adjusting for other factors, the odds of sustaining perineal trauma increased with increased birth weight (OR 2.878; p= 0.005) and decreased with increasing parity (OR 0.037; p=0.000). The prevalence of perineal tears as revealed by the study was 38.8%. This study recommended evidence based practice during labour and delivery in order to improve pelvic floor outcomes as well as reduce operative deliveries and long term morbidities.
2022
Background: Obstetric perineal injury is a major contributor to women's reproductive health problems. More than 60% of women suffer varying degrees of obstetric perineal injuries during vaginal delivery requiring repair. This study determined the risk factors associated with perineal injury. Method: Prospective observational study of 356 women who had singleton term vaginal delivery between 1stApril and 31stMay, 2018 at the KBTH. Sociodemographic and clinical data of participants were collected and analysed to determine association between variables. A p-value of <0.05 was considered statistically significant. Results: Two hundred and thirty-six women (66.29%) had vaginal deliveries with no perineal injuries comprising 81 primiparous and 155 multiparous women. Perineal injury among the study participants were 120/356 (33.71%) while perineal injury for first degree, second degree, third degree and fourth degree were 75/356 (21.07%), 41/356 (11.52%), 2/356 (0.56%), 2/356 (0.56%) respectively. A total of 948 vaginal deliveries was conducted during the study period. The odds of developing a perineal injury was 8 times higher among participants with previous surgery on genital tract (OR, 8.29 [95% CI 2.69-25.6]; p<0.001) and 18 times higher among participants with previous postpartum complication (OR, 18.00 [95% CI 4.06-79.71], p<0.001). Babies with birth weights ≥2.5kg had 4.11 increased odds of developing perineal injury when compared to those with birth weights <2.5kg (OR, 4.11 [95% CI, 1.70-9.98] p=0.001). Vacuum delivery was strongly associated with a 4.81 odds perineal injury (OR, 4.81 [95% CI, 1.22-18.9] p<0.014). Conclusion: The incidence of perineal injury among women who had vaginal delivery at the KBTH maternity during the study period of (12.66%) was high compared to other studies from the West African Subregion. Risk factors such as previous postpartum complication, episiotomy, and gestational age at delivery, head circumference of the baby, asthma, hypertension and past genital tract surgery were significantly associated with perineal injury. Early identification of women at risk of perineal injury could help with interventions to reduce the incidence of this complication during childbirth.
BMJ Open, 2019
ObjectiveSexuality is an important aspect of human identity and contributes significantly to the quality of life in women as well as in men. Impairment in sexual health after vaginal delivery is a major concern for many women. We aimed to examine the association between degree of perineal tear and sexual function 12 months postpartum.DesignA prospective cohort studySettingFour Danish hospitals between July 2015 and January 2019ParticipantsA total of 554 primiparous women: 191 with no/labia/first-degree tears, 189 with second-degree tears and 174 with third-degree/fourth-degree tears. Baseline data were obtained 2 weeks postpartum by a questionnaire and a clinical examination. Sexual function was evaluated 12 months postpartum by an electronic questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12)) and a clinical examination.Primary outcome measuresTotal PISQ-12 score and dyspareuniaResultsEpisiotomy was performed in 54 cases and 95 women ha...
Journal of Psychiatry Psychology and Behavioral Research, 2022
Spontaneous vaginal deliveries allows perineal lacerations. The level of resistance of a person to perineal lacerations varies widely. The risk of developing postpartum depression is experienced by different groups of women. In the early months after delivery, depression is the most common morbidity in postpartum women. The presence of perineal lacerations can be a factor in the development of postpartum depression. Stress and anxiety disorders can be caused by the occurrence of grade 3 and 4 perineal lacerations. This study looked at the potential effect of perineal laceration on the incidence of postpartum depression in women with vaginal delivery. This systematic review used study research that related to postpartum depression and perineal lacerations. Articles that are relevant are searched for by the author on Google Scholar, ScienceDirect, and Pubmed from the last 5 years (2015-2020). By 5 of the 77 studies were discussed in the review. The studies were conducted in United Sta...
Sexual Dysfunction Among Women at Four to Six Months Postpartum: A Study in a Primary Care Setting
Malaysian Journal of Public Health Medicine
Sexual dysfunction in women is a significant health problem that harms marriage stability. Women in the Western countries were reportedly being affected by this condition after childbirth but the magnitude of the problem in our local setting is still unknown. The aim of this cross-sectional study was to determine the prevalence of women with sexual dysfunction at four to six months postpartum and its possible risk factors in an urban primary care setting. The participants were given a set of questionnaire, consisting of three parts; i) sociodemographic and maternal characteristics ii) Malay version of Female Sexual Function Index and iii) Malay DASS-21 questionnaire. Responses from 249 women were analyzed. More than half (57.0%,n=142) were found to have sexual dysfunction. The most prevalent types of sexual dysfunction reported by the affected women were sexual satisfaction disorder (98.6%), followed by arousal disorder (58.5%) and lubrication disorder (28.9%). Three factors were fo...
The Internet Journal of Epidemiology
Aim: To evaluate the effect of postpartum perineal trauma to the frequencies of perineal pain, of urinary incontinence, and of dyspareunia.Material-Methods: This cross sectional study was done between April 1 st and July 31 st 2005 in Eskisehir. Study group was occurred from 1500 women. The women's first deliveries are vaginal, only one fetus, vertex presentation, term, and normal childbirth weight. Prepared in accordance with the literature a questionnaire was applied with face to face method.Results: Urinary incontinence, perineal pain, and dyspareunia frequencies were higher in women with perineal trauma than women without perineal trauma in their first childbirth (for each one p<0.05). Conclusion: This study has shown that the effect of postpartum perineal trauma urinary incontinence, perineal pain and dyspareunia frequencies increases.
Suez Canal University Medical Journal, 2018
Introduction: Female sexual dysfunction (FSD) is an underestimated common problem with serious effects on women's quality of life. Female sexual function changes considerably during pregnancy and the postpartum period. During this time, the perineum and pelvic floor muscles are damaged. Type of delivery and perineal trauma during childbirth is associated with sexual problems after childbirth. There is controversy over the effect of mode of delivery on female sexual function. Aim: The aim of this study was to assess the relationship between mode of delivery and postpartum female sexual function. Materials and Methods: This was a prospective, descriptive study. 42 women (age range from 18-35years) were recruited in this cross-sectional study. Females were divided into two groups according to their mode of delivery, including: group A, normal labour (NL) (group NL, N = 21); group B, cesarean section (C/S) (group C/S, N = 21). Sexual function was assessed using Female Sexual Function Index (FSFI) and Depression, Anxiety, and stress scale)DASS-21(. Results: There were statistically significant decrease of desire, arousal, orgasm and total score of FSFI and while there was significant increase in lubrication and satisfaction domains in NVD group when compared to CS group. The study showed that, there was significant decrease in depression, anxiety and stress in NVD group when compared to CS group according to DASS-21 score. Conclusions: Mode of delivery had actually affected female sexual function in postpartum period.
The Relationship Between Mode of Delivery and Sexual Health Outcomes after Childbirth
The journal of sexual medicine, 2015
Several factors are implicated in the women's sexuality after childbirth. Nevertheless, there is conflicting evidence about the influence of mode of delivery (MD) AIM: To prospectively evaluate the relationship between MD and sexual health outcomes after childbirth METHODS: A prospective cohort study conducted between May 2005 and March 2007 included 831 pregnant women recruited from primary care clinics of the public sector in São Paulo, Brazil. The exposure variable was MD: uncomplicated vaginal delivery (spontaneous vaginal delivery without episiotomy or any kind of perineal laceration); complicated vaginal delivery (either forceps or normal, with episiotomy or any kind of perineal laceration) and cesarean delivery. Socio-demographic and obstetric data were obtained through a questionnaire applied during the antenatal and postnatal period. Crude and adjusted risk ratios, with 95% confidence intervals, were calculated using Poisson regression to examine the associations betwee...