Awareness of the methods of primary and secondary childbirth trauma prevention among parturients

Česká verzia

Authors: A. Veverková ¹; V. Kališ ^1,2; Z. Rušavý ^1,2
Authors place of work: Gynekologicko-porodnická klinika LF UK a FN, Plzeň, přednosta doc. MUDr. Z. Novotný, CSc. ¹; Biomedicínské centrum LF UK, Plzeň, vědecký ředitel projektu doc. MUDr. M. Štengl, Ph. D. ²
Published in the journal: Ceska Gynekol 2017; 82(4): 327-332

Summary

Objective:
To evaluate the awareness of fresh mothers regarding the primary prevention of pelvic floor disorders after childbirth. The secondary objective was to identify sources of information, reality of childbirth trauma prevention and attitude to pelvic floor muscle training.

Design:
Prospective survey study.

Setting:
Department of Gynecology and Obstetrics, University Hospital and Medical Faculty in Pilsen, Charles University.

Methods:
We included 202 women after a vaginal delivery at our center from 6/2015 to 12/2015. These women completed anonymous questionnaire with six questions.

Results:
83% of respondents were informed regarding the possibility of primary prevention of childbirth, nulliparas were informed better (88%). The main source of information was the Internet (46%), while only 5% of women received information from their doctor. Despite the high awareness of postpartum trauma prevention, less than half of interviewed women actually performed it (35%). The most widely used method was the massage of the perineum (29%), vaginal dilatation balloons were used less (7%) and alternative methods were pursued by only 4% of women. Experience with pelvic floor muscle exercises had 79% of women, while 90% wanted to exercise after the delivery.

Conclusion:
Awareness of mothers regarding primary and secondary prevention of pelvic floor disorders is satisfactory. Nevertheless, the information from doctors is inadequate. Despite high awareness, the antepartum prevention methods are used relatively rarely. The study clearly shows the level of awareness and reality of primary and secondary prevention of pelvic floor disorders in our region.

Keywords:
pelvic floor disorders, childbirth, perineal massage, vaginal dilatation balloons, postpartum trauma, pelvic floor muscle exercises

Zdroje

1. Barrett, G., Pendry, E., Peacock, J., et al. Women‘s sexual health after childbirth. BJOG: An International Journal of Obstetrics & Gynaecology, 2000, 107(2), p. 186–195.

2. Beckmann, MM., Stock, OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev, 2013, p. 4.

3. Bø, K., Hilde, G., Jensen, JS., Siafarikas, F., Engh, ME. Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women. Int Urogynecol J, 2013, 24(12), p. 2065–2070.

4. Bohatá, P., Dostálek, L. The possibility of antepartal prevention of episiotomy and perineal tears during delivery. Ces Gynek, 2016, 81(3), p. 192.

5. Boyle, R., Hay-Smith, E., Cody, JD., Mørkved, S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev, 2012, 10, CD.

6. Brito, LGO., Ferreira, CJ., Duarte, G., et al. Antepartum use of Epi-No birth trainer for preventing perineal trauma: systematic review. Int Urogynecol J, 2015, p. 1–8.

7. Carroli, G., Mignini, L. Episiotomy for vaginal birth. Cochrane Database Syst Rev, 2009(1), CD000081.

8. Du, Y., Xu, L., Ding, L., et al. The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: a systematic review with meta-analysis. Int Urogynecol J., 2015, 26(10), p. 1415–1427.

9. Gyhagen, M,, Bullarbo, M,, Nielsen, T., Milsom, I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG, 2013, 120(2), p. 152–160.

10. Gyhagen, M., Bullarbo, M., Nielsen, T., Milsom, I. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG, 2013, 120(2), p. 144–151.

11. Hagen, S., Glazener, C., Mcclurg, D., et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial. Lancet, 2016.

12. Hillebrenner, J., Wagenpfeil, S., Schuchardt, R., et al. Initial experiences with primiparous women using a new kind of Epi-no labor trainer. Zeitschrift Geburtshilfe Neonatologie, 2000, 205(1), p, 12–19.

13. Kamisan Atan, I., Shek, K., Langer, S., et al. Does the Epi-No^® birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial. BJOG, 2016.

14. Kok, J., Tan, K., Koh, .S, et al. Antenatal use of a novel vaginal birth training device by term primiparous women in Singapore. Singapore Med J., 2004, 45, p. 318–323.

15. Kovacs, GT., Heath, P., Heather, C. First Australian trial of the birth-training device Epi-No: A highly significantly increased chance of an intact perineum. Austral New Zealand J Obstet Gynaecol, 2004, 44(4), p. 347–348.

16. Labrecque, M., Eason, E., Marcoux, S., et al. Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Amer J Obstet Gynecol, 1999, 180(3), p. 593–600.

17. Lothian, JA. Moving forward: the power of collaboration. J Perinatal Education, 2013, 22(1), p. 3–5.

18. Macarthur, C., Glazener, C., Lancashire, R., et al. Faecal incontinence and mode of first and subsequent delivery: a six-year longitudinal study. BJOG, 2005, 112(8), p. 1075–1082.

19. Mccandlish, R., Bowler, U., Van Asten, H., et al. A randomised controlled trial of care of the perineum during second stage of normal labour. Br J Obstet Gynaecol, 1998, 105(12), p. 1262–1272.

20. Necesalova, P., Karbanova, J., Rusavy, Z., et al. Mediolateral versus lateral episiotomy and their effect on postpartum coital activity and dyspareunia rate 3 and 6 months postpartum. Sexual Reprod Healthcare, 2016, 8, p. 25–30.

21. Ruckhäberle, E., Jundt, K., Baeuerle, M., et al. Prospective randomised multicentre trial with the birth trainer EPI-NO^® for the prevention of perineal trauma. Austral New Zealand J Obstet Gynaecol, 2009, 49(5), p. 478–483.

22. Rusavy, Z., Karbanova, J., Jansova, M., Kalis, V. Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients. Int J Gynecol Obstet, 2016, 135(3), p. 290–294.

23. Rušavý, Z., Kališ, V., Landsmanová, J.,et al. Perineální audit: důvody pro více než 1000 epiziotomií. Čes Gynek, 2011, 76(5), s. 378–385.

24. Skinner, EM., Dietz, HP. Psychological and somatic sequelae of traumatic vaginal delivery: A literature review. Austral New Zealand J Obstet Gynaecol, 2014.

25. Sleep, J., Grant, A., Garcia, J., et al. West Berkshire perineal management trial. Brit Med J, 1984, 289(6445), p. 587.