Pelvic floor symptoms and quality of life changes during first pregnancy: a prospective cohort study

Abstract

Introduction We describe pelvic floor function in nulliparous pregnant women. Materials/Methods Nulliparous midwifery patients completed the Incontinence Severity Index (ISI), Pelvic Floor Impact Questionnaire (PFIQ-7), Wexner Fecal Incontinence Scale (W), and answered questions about sexual activity and perineal pain at baseline during the first (T1), second (T2), or third trimester (T3) and repeated in late T3. They also underwent a Pelvic Organ Prolapse Quantification (POPQ) exam at their baseline visit. Data were compared across trimesters. ANOVA and logistic regression accounted for repeated measures and was controlled for age and education. Results We recruited 627 women. In T1, 124 women gave baseline data and completed questionnaires, 403 in T2, and 96 in early T3 (496 repeated questionnaires in later T3). Besides an increase in genital hiatus and perineal body (all adjusted p < .05), physical exam measures did not differ between trimesters. As pregnancy progressed, urinary incontinence (UI) (T1=33, T2=44, T3=69% women with ISI >0, all comparisons p<.02) and IIQ-7 scores increased. Fecal incontinence (FI) increased (T1=8, T2=15, T3=16% from T2 to T3, p=.04), while CRAIQ-7 scores did not increase. Perineal pain increased (T1=17, T2=18 and T3 = 40%, all adjusted p <.001), and sexual activity decreased as pregnancy progressed (T1= 94, T2 = 90, T3 = 77% sexually active, T1 vs T3 and T2 vs T3, p <.001). Conclusions During pregnancy, women experience worsening UI, FI and perineal pain. UI symptoms are associated with a negative impact on quality of life. Sexual activity decreases and POPQ stage does not change.

International Fitness Scale—IFIS: Validity and association with health‐related quality of life in pregnant women

“…It has also been shown that HRQoL might be compromised during pregnancy and that higher physical fitness plays a positive role in HRQoL . As the IFIS is a rather simple and quick‐to‐use tool that could be implemented in clinical practice, it is of clinical interest to investigate whether the IFIS can discriminate between both objectively measured physical fitness and HRQoL levels in pregnant women.…”

Urinary incontinence and quality of life according to trimesters in pregnancy

“…Ülkemizde yapılan çalışmalarda gebelikte Üİ görülme sıklığı %21,7 ile %42,4 arasında saptanmıştır 2,12,13,14,15,16,17 . Vücut ağırlığının ve abdominal basıncın artmasıyla gebelik ilerledikçe, birinci trimesterden üçüncü trimestere doğru Üİ şiddeti ve görülme sıklığı artma eğilimindedir 18 . Gebelikte hormon üretiminin artması pelvik taban kaslarının ve bağ dokunun relaksasyonuna neden olarak mevcut Üİ şiddetini arttırabilmektedir 19 .…”

“…Gebelikte Üİ oluşmasının yaşamın ilerleyen döneminde sorunun tekrarlama olasılığını arttıracağı da düşünülmektedir 20 . Gebelikte Üİ, kadınların yaşam kalitelerini olumsuz etkilemektedir 2,12,15,16,18,21 . Ayrıca yapılan çalışmalarda gebelikte sık ve fazla miktarda idrar kaçırmanın yaşam kalitesini azalttığı da görülmüştür 13,17,22,23 .…”

Evaluation of Incontinence Prevalence and Risk Factors in Nulliparous Pregnant Women

“…[11][12][13][14][15] İstem dışı idrar kaçırma sorunu kadınlarda anksiyete, depresyon, utanma duygusu, özgüven kaybı ve cinsel fonksiyonların olumsuz etkilenmesine yol açarak yaşam kalitesi üzerine olumsuz etki göstermektedir. [16][17][18] Bu çalışmada, primigravid gebeler arasında idrar kaçırma prevalansının, potansiyel risk faktörlerinin ve inkontinansın yaşam kalitesine etkisinin değerlendirilmesi amaçlandı.…”