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Title: The prevalence and obstetric antecedents of pelvic floor dysfunction.
Author: Dolan, Lucia Margaret
ISNI:       0000 0001 3427 6484
Awarding Body: Newcastle University
Current Institution: University of Newcastle upon Tyne
Date of Award: 2007
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It has long been considered that aspects of pregnancy and child birth play a role in the aetiology of pelvic floor dysfunction (PFD). Most women have their first pregnancy in their 20's, yet the peak time for presentation with symptoms is 2 or 3 decades later. The studies embodied in this thesis are designed to examine the prevalence and antecedent risk factors ofPFD in women 20 years after their first delivery. Unique aspects ofthe studies described here are: identification of a consecutive group of women having their first pregnancies over a short time period in a single hospital; the est~blishmentofcurrent contact information for these women 20 years later using the NHS Strategic Tracing System (NSTS); the use ofa robust obstetric database, the Standard Maternity Information System (SMIS) effective at the time of the index pregnancies; and the use of the validated Sheffield Pelvic Floor Assessment Questionnaire (Sheffield-PAQ© v3) to determine current symptoms and their impact on quality of life. Mothers of index cases were also contacted to assess familial risk. PFD was confirmed to be extremely common, with symptoms affecting half of women 20 years after their first pregnancy; 4:10 women reported urinary incontinence (UI), 2:10 had anal incontinence (AI), and 1:8 had prolapse. Symptoms were troublesome in over 50% (prolapse) and over 70% CUI & AI). Logistic regression analyses indicated that caesarean section was protective against UI, faecal incontinence (FI) and mild prolapse. Instrumental delivery was a risk factor for flatal and FI; obesity was a risk factor for all three symptoms. A familial risk for UI and AI was identified. Vaginal birth is a significant risk factor for long term symptoms ofPFD. However, some women may have a predisposition, possibly genetic, to develop symptoms which is independent of obstetric history.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available