Archives of Gynecology and Obstetrics最新文献

Purpose: Postpartum women commonly experience sexual dysfunction; however, little is known regarding the effect of breastfeeding on sexual function and postpartum women's interest in treatment. We aimed to evaluate sexual function and genitourinary symptoms based on infant-feeding status and assess desire for treatment.

Methods: Cross-sectional observational study of women 5-6 months postpartum following singleton delivery was performed. Participants were grouped based on self-reported infant-feeding status: (1) primarily breastfeeding (BF) and (2) primarily formula feeding (FF). Female Sexual Function Index (FSFI) and Day-to-day Impact on Vaginal Aging (DIVA) questionnaires and interest in treatment were compared.

Results: In total, 125 women were included with 61 (49%) breastfeeding and 64 (51%) formula feeding. Compared to FF women, BF women were less likely to identify as African American (47% vs 79%; SD 0.8) or have Medicaid (28% vs 66%; SD 0.9). No other large differences were noted. BF women had significantly lower FSFI score indicating poorer sexual function (20.8 (IQR 10, 24) BF vs 24.5 (IQR 19.5, 27.8) FF, p = 0.009). Both cohorts reported low bother from vaginal symptoms and low interest in treatment of symptoms with BF cohort reporting higher interest in use of vaginal lubricants (69% BF vs 30% FF, SD 0.8). Factors associated with lower FSFI score were BF, perineal laceration, use of progesterone long-acting reversible contraception, and single relationship status.

Conclusion: Both breastfeeding and formula feeding women experienced high rates of sexual dysfunction but low bother from vaginal symptoms and low interest in treatment. Further research is needed to explore these findings and assess postpartum sexual health.

Purpose: Investigate the relationship between female pelvic floor muscle (PFM) function and body composition.

Methods: Cross-sectional study-participants answered sociodemographic and urogynecological questions. The amount of fat mass was measured by dual-emission X-ray densitometry (DXA), and subcutaneous fat thickness was assessed by abdominal ultrasound. PFM assessment was performed using the Modified Oxford Scale and vaginal manometry. Descriptive analysis, independent t test, spearman correlation, and univariate regression were performed.

Results: Ninety-nine women were included. All body composition variables evaluated, except subcutaneous fat thickness, indicated that women with a higher concentration of fat in the pelvic, android, and visceral region have lower maximum voluntary PFM contraction strength assessed by Modified Oxford Scale and manometry. The univariate model pointed out that the fat concentration increases the chances of reduced PFM strength in the entire body (0.6%), android (5.4%), visceral region (25.3%), and pelvic (89.9%). There was a correlation between the concentration of total, pelvic, and android fat with MVC/average peak.

Conclusion: The accumulation of "total", "pelvic", "android", and "visceral" fat mass is correlated with reduction in PFM strength, and there is an association between MVC and the variables of total and segmented fat. However, pelvic fat concentration is predictive in 89.9% of cases.

There is a general lack of awareness regarding how the mode of delivery can significantly influence the omics composition of biological samples such as umbilical cord blood and amniotic fluid. To address this, we analyzed the impact of delivery mode on proteomic and metabolomic profiles in a cohort of 40 healthy pregnant women without complications, including 16 who had vaginal delivery (VD), 16 who underwent elective cesarean delivery by maternal request (CS), and 8 who had intrapartum cesarean section (Intra_CS). Using label-free liquid chromatography-tandem mass spectrometry (LC-MS/MS) for proteomic and untargeted metabolomic analyses, we compared amniotic fluid and cord blood samples across delivery modes. The amniotic fluid proteomic and metabolomic profiles of CS women exhibited clear separation from those of VD individuals, whereas only the proteomic profiles of the Intra_CS group differed when compared to the CS group. In cord blood, metabolomic profiles differed between CS and VD women, but proteomic profiles showed no separation. These findings highlight the significant impact of delivery mode on omics profiles, particularly amniotic fluid proteomics and metabolomics, and cord blood metabolomics. Larger studies are needed to validate these findings and expand their generalizability to broader populations.

Introduction: Pelvic organ prolapse is a distressing condition affecting women. Pessary therapy is a conservative and effective treatment option. However, 20-60% of women discontinue pessary treatment within 24 months.

Objective: To identify patient characteristics associated with discontinuation of pessary treatment for symptomatic pelvic organ prolapse up to 24 months and to explore whether a prediction model can be developed.

Study design: Prospective observational study in 22 Dutch hospitals with a follow-up duration of 24 months.

Method: Baseline patient characteristics from 6 different domains were compared between women who continued pessary therapy and women who discontinued pessary therapy within 24 months. Women with initial fitting failure were not included in analysis. Univariable and multivariable analysis were applied to identify predictors.

Results: Of the 251 women included in analysis, 102 stopped using a pessary at 24 months (40.6%). After multivariable analysis, age (OR 0.95, 95% CI 0.92-0.98, p < 0.001) and the presence of patient-reported allergies (OR 2.48, 95% CI 1.32-4.66, p = 0.005) were found to be predictive for pessary discontinuation within 24 months. These two factors explain 11% of the models' variance. However, in 49% of patient-reported allergies, the allergy was not specified.

Conclusion: Younger women and those who reported allergies at baseline were less likely to continue pessary use. However, the high number of unspecified reported allergies and the lack of a clear scientific explanation, suggests that a direct causal link is unlikely and warrants additional research.