Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia

Abstract

Pelvic floor disorders are common and of concern, as the majority of maternity healthcare providers seldom discuss this issue with patients compared to other antenatal issues. The aim of this study is to determine the prevalence and to assess the knowledge and awareness of pelvic floor disorder (PFD) among pregnant women in a tertiary centre in Malaysia. We also aim to assess the association between women’s risk factors regarding their knowledge and awareness of pelvic floor disorder so that primary prevention strategies can be planned, initiated and implemented in the future. This is a cross-sectional study with a total of four hundred twenty-four pregnant women that were recruited over a 6-month duration from May to November 2017 in a tertiary centre in Malaysia. The Pelvic Floor Distress Inventory (PFDI-20) was used to evaluate pelvic floor distress symptoms during pregnancy, namely urinary incontinence, pelvic organ prolapse and faecal incontinence. A validated Prolapse and Incontinence Knowledge Questionnaire (PIKQ), which consists of 24 items, was used to assess respondents’ knowledge about urinary incontinence (UI) and pelvic organ prolapse (POP). A total of 450 participants were approached, but 424 participants agreed to participate, showing a response rate of 94.3%. The median age was 31.5 years old, and 33.3% were primiparity. Overall, 46.1% of pregnant women had at least one symptom of pelvic floor disorder during pregnancy. Of these, 62.3% experienced urinary incontinence, 41.1% experienced symptoms of pelvic organ prolapse, and 37.8% experienced symptoms of faecal incontinence. The overall median score of PIKQ was 12.0 (8.0, 17.0). The median score for PIKQ—UI was 7.0 (5.0, 9.0) and the median score for PIKQ—POP was 6.0 (4.0, 8.0). There were 341 (80.4%) pregnant women that had a low level of knowledge in UI, and 191 (45.0%) had a low level of knowledge in POP. Having a tertiary level of education and receiving antenatal specialist care were both associated with better proficiency in both the PIKQ—UI (p < 0.001) and PIKQ—POP (p < 0.001) subscales. Pelvic floor disorder during pregnancy was common. A knowledge of pelvic floor disorder was lacking among pregnant women in this study. Having a tertiary education and receiving antenatal specialist care were both associated with better knowledge proficiency. This study hopefully serves as a basic platform for future educational programs to bridge the knowledge gaps in PFD among pregnant women.

Validation of the Arabic Linguistic Version of the Prolapse and Incontinence Knowledge Questionnaire

“…Education emerged as a significant factor influencing knowledge proficiency, which is consistent with previous research [3,14,20]. Specifically, patients with higher education levels displayed more knowledge about UI, although no significant differences were observed for POP, as shown in Table 4.…”

Knowledge, attitudes, and practices of pelvic floor muscle exercises among pregnant women visiting public hospitals

“…The lack of knowledge about pelvic floor disorders can also be a reason for poor knowledge of PFMEs among pregnant women, which may be due to the limited access of women to healthcare facilities, the embarrassment of discussing pelvic floor disorder symptoms with the healthcare provider, fear of social stigma, and peer pressure [19,35,36]. Furthermore, a lack of knowledge about the diverse symptoms of pelvic floor disorders keeps pregnant women asymptomatic, barring them from seeking medical care for such disorders and ultimately limiting their likelihood of understanding preventive and curative modalities [37,38].…”

Effect of human umbilical cord stem cells (HUMSC) administration on collagen expression in the anterior vaginal wall in menopausal rats

“…The prevalence report shows that POP affects 30% of middle-aged women in China, 19% in Australia, and over 50% of women aged over 60 years in the United States. By 2050, symptomatic POP is expected to affect at least 46% of the women population in the United States (5) . Although in Denpasar City of Indonesia, POP was reported in approximately 11.38% of cases within 2 years of evaluation (6,7) .…”