The impact of first pregnancy and delivery on pelvic floor dysfunction

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dc.contributor.advisor Khashan, Ali en
dc.contributor.advisor O'Reilly, Barry A. en
dc.contributor.advisor Kenny, Louise C. en
dc.contributor.author Durnea, Constantin M.
dc.date.accessioned 2015-05-05T14:20:27Z
dc.date.available 2015-05-05T14:20:27Z
dc.date.issued 2014
dc.date.submitted 2015
dc.identifier.citation Durnea, C. 2014. The impact of first pregnancy and delivery on pelvic floor dysfunction. PhD Thesis, University College Cork. en
dc.identifier.endpage 220
dc.identifier.uri http://hdl.handle.net/10468/1790
dc.description.abstract Background: The first childbirth has the greatest impact on a woman’s pelvic floor when major changes occur. The aim of this study was to comprehensively describe pelvic floor dysfunction (PFD) in young nulliparous women, and its correlation with postnatal pathology. Methods: A prospective study was performed at Cork University Maternity Hospital, Ireland. Initially 1484 nulliparous women completed the validated Australian Pelvic Floor Questionnaire at 15 weeks’ gestation and repeatedly at one year postnatally (N=872). In the second phase, at least one year postnatally, 202 participants without subsequent pregnancies attended the clinical follow up which included: pelvic organ prolapse quantification, a 3D-Transperineal ultrasound scan and collagen level assessment. Results: A high pre-pregnancy prevalence of various types of PFD was detected, which in the majority of cases persisted postnatally and included multiple types of PFD. The first birth had a negative impact on severity of pre-pregnancy symptoms in <15% of cases. Apart from prolapse, vaginal delivery, including instrumental delivery did not increase the risk of PFD symptoms, where as Caesarean section was protective for all types of PFD. The first birth had a bigger impact on pre-existing symptoms of overactive bladder compared to stress urinary incontinence. Pelvic organ prolapse is extremely prevalent in young primiparous women, however usually it is low grade and asymptomatic. Congenital factors and high collagen type III levels play an important role in the aetiology of pelvic organs prolapse. Levator ani trauma is present in one in three women after the first pregnancy and delivery. Conclusion: The main damage to the pelvic floor most likely occurs due to an undiagnosed congenital intrinsic weakness of the pelvic floor structures. PFD is highly associated with first childbirth, however it seems that pregnancy and delivery are contributing factors only which unmask the congenital intrinsic weakness of the pelvic floor support. en
dc.description.sponsorship Health Research Board (SCOPE HRBI CSA 2007/2); en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2014, Constantin Durnea. en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/3.0/ en
dc.subject Pelvic floor dysfunction en
dc.subject POP en
dc.subject POP-Q en
dc.subject ELISA test en
dc.subject Collagen en
dc.subject LAM en
dc.subject LAM trauma en
dc.subject RF en
dc.subject Urinary incontinence en
dc.subject Urinary urgency en
dc.subject Urinary frequency en
dc.subject Coital incontinence en
dc.subject Faecal incontinence en
dc.subject Faecal urgency en
dc.subject Obstructed micturition en
dc.subject Obstructed defaecation en
dc.subject Bother en
dc.subject Impact on social life en
dc.subject Pelvic organ prolpase en
dc.subject Cystocele en
dc.subject Rectocele en
dc.subject Uterine prolapse en
dc.subject Transperineal 3D scan en
dc.subject Joint hypermobility en
dc.subject Family history collagen disorders en
dc.subject Collagen disease en
dc.subject Dyspareunia en
dc.subject Vaginal laxity en
dc.subject Vaginismus en
dc.subject Sexual satisfaction en
dc.subject Levator ani muscle trauma en
dc.subject Pre-pregnancy en
dc.subject Post-natal en
dc.subject Nulliparous en
dc.subject Nulliparas en
dc.subject Primipara en
dc.subject Primiparous en
dc.subject Primip en
dc.subject Risk factors en
dc.subject Mode of delivery en
dc.subject Caesarean section en
dc.subject Forceps delivery en
dc.subject Instrumental delivery en
dc.subject Pre-pregnancy symptoms en
dc.title The impact of first pregnancy and delivery on pelvic floor dysfunction en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral Degree (Structured) en
dc.type.qualificationname PhD (Medicine and Health) en
dc.internal.availability Full text available en
dc.check.info No embargo required en
dc.description.version Accepted Version
dc.contributor.funder Health Research Board en
dc.contributor.funder Science Foundation Ireland en
dc.contributor.funder Continence Foundation Ireland en
dc.description.status Not peer reviewed en
dc.internal.school Obstetrics and Gynaecology en
dc.check.type No Embargo Required
dc.check.reason No embargo required en
dc.check.opt-out Not applicable en
dc.thesis.opt-out false
dc.check.embargoformat Not applicable en
ucc.workflow.supervisor barry.oreilly@hse.ie
dc.internal.conferring Summer Conferring 2015


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© 2014, Constantin Durnea. Except where otherwise noted, this item's license is described as © 2014, Constantin Durnea.
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