PMID- 26874524
OWN - NLM
STAT- MEDLINE
DCOM- 20170823
LR  - 20220321
IS  - 1433-3023 (Electronic)
IS  - 0937-3462 (Print)
IS  - 0937-3462 (Linking)
VI  - 27
IP  - 8
DP  - 2016 Aug
TI  - Perineal body stretch during labor does not predict perineal laceration, 
      postpartum incontinence, or postpartum sexual function: a cohort study.
PG  - 1193-200
LID - 10.1007/s00192-016-2959-y [doi]
AB  - INTRODUCTION AND HYPOTHESIS: The perineum stretches naturally during obstetrical 
      labor, but it is unknown whether this stretch has a negative impact on pelvic 
      floor outcomes after a vaginal birth (VB). We aimed to evaluate whether perineal 
      stretch was associated with postpartum pelvic floor dysfunction, and we 
      hypothesized that greater perineal stretch would correlate with worsened 
      outcomes. METHODS: This was a prospective cohort study of primiparous women who 
      had a VB. Perineal body (PB) length was measured antepartum, during labor, and 
      6 months postpartum. We determined the maximum PB (PBmax) measurements during the 
      second stage of labor and PB change (DeltaPB) between time points. Women completed 
      functional questionnaires and had a Pelvic Organ Prolapse Quantification (POP-Q) 
      system exam 6 months postpartum. We analyzed the relationship of PB measurements 
      to perineal lacerations and postpartum outcomes, including urinary, anal, and 
      fecal incontinence, sexual activity and function, and POP-Q measurements. 
      RESULTS: Four hundred and forty-eight women with VB and a mean age of 
      24 +/- 5.0 years with rare (5 %) third- or fourth-degree lacerations were assessed. 
      During the second stage of labor, 270/448 (60 %) had perineal measurements. Mean 
      antepartum PB length was 3.7 +/- 0.8 cm, with a maximum mean PB length (PBmax) 
      during the second stage of 6.1 +/- 1.5 cm, an increase of 65 %. The change in PB 
      length (DeltaPB) from antepartum to 6 months postpartum was a net decrease 
      (-0.39 +/- 1.02 cm). PB change and PBmax were not associated with perineal 
      lacerations or outcomes postpartum (all p > 0.05). CONCLUSIONS: PB stretch during 
      labor is unrelated to perineal laceration, postpartum incontinence, sexual 
      activity, or sexual function.
FAU - Meriwether, Kate V
AU  - Meriwether KV
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA. kvmeri01@exchange.louisville.edu.
AD  - Department of Obstetrics & Gynecology, University of Louisville, 550 S. Jackson, 
      Louisville, KY, 40202, USA. kvmeri01@exchange.louisville.edu.
FAU - Rogers, Rebecca G
AU  - Rogers RG
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA.
FAU - Dunivan, Gena C
AU  - Dunivan GC
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA.
FAU - Alldredge, Jill K
AU  - Alldredge JK
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA.
FAU - Qualls, Clifford
AU  - Qualls C
AD  - Department of Biostatistics, Multidisciplinary Research Facility, Clinical 
      Sciences and Translational Center, University of New Mexico, 2705 Frontier Ave., 
      First Floor, Room 120, Albuquerque, NM, 87131, USA.
FAU - Migliaccio, Laura
AU  - Migliaccio L
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA.
FAU - Leeman, Lawrence
AU  - Leeman L
AD  - Department of Obstetrics & Gynecology, University of New Mexico, 2211 Lomas NE, 
      4th Floor, Albuquerque, NM, 87131, USA.
AD  - Department of Family and Community Medicine, University of New Mexico, 2400 
      Tucker NE, Albuquerque, NM, 87131, USA.
LA  - eng
GR  - R01 HD049819/HD/NICHD NIH HHS/United States
GR  - T32 CA060396/CA/NCI NIH HHS/United States
GR  - UL1 TR000041/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20160213
PL  - England
TA  - Int Urogynecol J
JT  - International urogynecology journal
JID - 101567041
SB  - IM
MH  - Adult
MH  - Fecal Incontinence/etiology/pathology
MH  - Female
MH  - Humans
MH  - Labor, Obstetric/physiology
MH  - Lacerations/*etiology/pathology
MH  - Obstetric Labor Complications/*pathology
MH  - Perineum/injuries/*pathology/physiopathology
MH  - Postpartum Period/physiology
MH  - Pregnancy
MH  - Prospective Studies
MH  - Sexual Dysfunction, Physiological/*etiology/pathology
MH  - Surveys and Questionnaires
MH  - Urinary Incontinence/*etiology/pathology
MH  - Young Adult
PMC - PMC5375164
MID - NIHMS853799
OTO - NOTNLM
OT  - Incontinence
OT  - Labor
OT  - Perineal body
OT  - Postpartum
OT  - Prolapse
OT  - Sexual function
EDAT- 2016/02/15 06:00
MHDA- 2017/08/24 06:00
PMCR- 2017/03/31
CRDT- 2016/02/15 06:00
PHST- 2015/11/12 00:00 [received]
PHST- 2016/01/18 00:00 [accepted]
PHST- 2016/02/15 06:00 [entrez]
PHST- 2016/02/15 06:00 [pubmed]
PHST- 2017/08/24 06:00 [medline]
PHST- 2017/03/31 00:00 [pmc-release]
AID - 10.1007/s00192-016-2959-y [pii]
AID - 10.1007/s00192-016-2959-y [doi]
PST - ppublish
SO  - Int Urogynecol J. 2016 Aug;27(8):1193-200. doi: 10.1007/s00192-016-2959-y. Epub 
      2016 Feb 13.