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Pelvic organ support among primiparous women in the first year after childbirth

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Abstract

Introduction and hypothesis

This study describes pelvic organ support after childbirth.

Methods

This ancillary analysis of the Childbirth and Pelvic Symptoms Imaging Study compares pelvic organ prolapse quantification 6–12 months after childbirth among three cohorts of primiparous women: vaginal delivery with sphincter tear (n = 106), vaginal delivery without sphincter tear (n = 108), and cesarean without labor (n = 39).

Results

Of participants, 31.2% had stage II support. Prolapse to or beyond the hymen was present in 14% after vaginal delivery with sphincter tear (95% confidence interval 8%, 22%), 15% (9%, 24%) after vaginal delivery without sphincter tear, and 5% (1%, 17%) after cesarean without labor (p = 0.23). A study of 132 women per group would be required for 80% power to test differences between 5% and 15%.

Conclusions

While these data provide insufficient power to dismiss a difference in pelvic organ support between modes of delivery, they add to our understanding of support following childbirth.

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Acknowledgments

Supported by grants from the National Institute of Child Health and Human Development (U01 HD41249, U10 HD41268, U10 HD41248, U10 HD41250, U10 HD41261, U10 HD41263, U10 HD41269, and U10 HD41267).

Conflicts of interest

Dr. Kenton serves as a consultant for Pfizer; the remaining authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gynecology & Obstetrics, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA

    Victoria L. Handa

  2. University of Utah, Salt Lake City, UT, USA

    Ingrid Nygaard

  3. Loyola University, Maywood, IL, USA

    Kimberly Kenton

  4. University of British Columbia, Vancouver, BC, Canada

    Geoffrey W. Cundiff

  5. University of Pittsburgh, Pittsburgh, PA, USA

    Chiara Ghetti

  6. University of Michigan, Ann Arbor, MI, USA

    Wen Ye

  7. University of Alabama at Birmingham, Birmingham, AL, USA

    Holly E. Richter

Authors
  1. Victoria L. Handa
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  2. Ingrid Nygaard
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  3. Kimberly Kenton
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  4. Geoffrey W. Cundiff
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  5. Chiara Ghetti
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  6. Wen Ye
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  7. Holly E. Richter
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Consortia

for the Pelvic Floor Disorders Network

Corresponding author

Correspondence to Victoria L. Handa.

Appendix

Appendix

Pelvic Floor Disorders Network Members

University of Alabama at Birmingham

Holly E. Richter, Ph.D., M.D., Principal investigator

Kathryn Burgio, Ph.D., Co-principal investigator

Patricia Goode, M.D., Co-investigator

R. Edward Varner, M.D., Co-investigator

Gregg Shore, M.D., Co-investigator

Franklin Tessler, M.D., Co-investigator

Mark Lockhart, M.D., MPH, Co-investigator

Velria Willis, R.N., B.S.N., Research coordinator

Baylor College of Medicine

Paul M. Fine, M.D., Principal investigator

Rodney A. Appell, M.D., Co-principal investigator

Peter K. Thompson, M.D., Co-investigator

Peter M. Lotze, M.D., Co-investigator

Naomi Frierson, Research coordinator

University of Iowa

Ingrid Nygaard, M.D., Principal investigator

Debra Brandt, R.N., Denise Haury, R.N. Research coordinators

Karl Kreder, M.D., Co-investigator

Catherine S. Bradley, M.D., Co-investigator

Satish Rao, M.D., Co-investigator

Johns Hopkins Medical Institutes

Geoffrey Cundiff, M.D., Principal investigator

Victoria Handa, M.D., Co-investigator

Mary Elizabeth Sauter, N.P., Research coordinator

Jamie Wright, M.D., Co-investigator

Loyola University, Chicago

Linda Brubaker, M.D., Principal investigator

Mary Pat FitzGerald, M.D., Co-principal investigator

Kimberly Kenton, M.D., Co-investigator

Dorothea Koch, R.N., Research coordinator

Charity Ball, R.N., Research coordinator

University of Michigan

Morton B. Brown, Ph.D., Principal investigator

John T. Wei, M.D., M.S., Co-principal investigator

Beverly Marchant, RN, BS, Project manager

John O.L. DeLancey, M.D., Co-investigator

Nancy K. Janz, Ph.D., Co-investigator

Dean G. Smith, Ph.D., Co-investigator

Patricia A. Wren, Ph.D., Co-investigator

Wen Ye, PhD, Statistician

James Imus, MS, Statistician

Yang Wang Casher, MS, Database programmer

University of North Carolina at Chapel Hill

Anthony G. Visco, M.D., Principal investigator

AnnaMarie Connolly, M.D., Co-investigator

John Lavelle, M.D., Co-investigator

Mary J. Loomis, R.N., Research coordinator

Anita K. Murphy, N.P., Research coordinator

Ellen C. Wells, M.D., Co-investigator

William Whitehead, Ph.D., Co-investigator

Julia Fielding, M.D., Co-investigator

University of Pittsburgh/Magee-Womens Hospitals

Halina Zyczynski, M.D., Principal investigator

Diane Borello-France, Ph.D., Co-investigator

Christiane Hakim, M.D., Co-investigator

Arnold Wald, M.D., Co-investigator

Judy A. Gruss, B.S., M.S., Research coordinator

Wendy Leng, M.D., Co-investigator

Pamela A. Moalli, M.D., Ph.D., Co-investigator

Steering Committee Chairman

Robert Park, M.D.

NICHD Project Scientist

Anne M. Weber, M.D., M.S.

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Handa, V.L., Nygaard, I., Kenton, K. et al. Pelvic organ support among primiparous women in the first year after childbirth. Int Urogynecol J 20, 1407–1411 (2009). https://doi.org/10.1007/s00192-009-0937-3

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  • DOI: https://doi.org/10.1007/s00192-009-0937-3

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