PL-LBA-2162

C. Palleschi¹, J. Hough^1,2, S. Guyatt²

¹Australian Catholic University, Physiotherapy, Brisbane, Australia, ²Mater Hospital, Physiotherapy, Brisbane, Australia

Background: Childbirth, particularly vaginal delivery, is an established risk factor contributing to the development of pelvic organ prolapse (POP) and obstructed defaecation (OD). However, recent studies suggest that physiological changes during pregnancy may predispose women to subsequent prolapse, regardless of mode of delivery. The aim of this study was to investigate the relationship between mode of delivery, bowel function and pelvic organ prolapse.

Purpose: The purpose of this study was to investigate the physiological changes that occur during the perinatal period to enhance understanding of the aetiology of obstructed defaecation and pelvic organ prolapse and the relationship between them.

Methods: A prospective longitudinal cohort sub-study was conducted, accessing data collected through the Mater Queensland Family Cohort Pilot study (2018-2019). Data from the Bristol stool chart, Constipation Assessment Scale, and Prolapse Questionnaire were collected at 24 and 36 weeks gestation, and 6 weeks postpartum

Results: The study enrolled 419 women, with a mean age of 31 ± 4.9 years. Two-thirds of women developed symptomatic POP during the study period, with the highest reported prevalence of 66.27% at 36 weeks gestation (mean score 2.86 SD 1.26 95%CI 2.70-3.02). POP scores significantly increased from 24 weeks to 36 weeks (2.45 +/- 0.79, 95%CI 2.35 - 2.55) and then decreased again at 6 weeks postpartum (2.3 +/- 0.88, 95%CI 2.28 - 2.50). Although no participants reported symptomatic OD, a significant positive correlation was found between POP and OD scores at all time periods in the study (p<0.01). At 24 weeks gestation, OD scores and Bristol stool chart classifications displayed a significant negative correlation of -0.2 (p=0.003), however, at 6 weeks postpartum there was a positive correlational relationship of 0.27 (p=0.000).

Conclusions: Advancing pregnancy is associated with an increased prevalence of POP, suggesting that the course of pregnancy itself contributes to the development of the disorder, rather than delivery alone. Despite no reported cases of OD, there is a significant positive relationship between POP and OD.

Implications: Pelvic organ prolapse affects 1 in 3 Australian women in their lifetime, and obstructed defecation has been reported in 14% of the female population. These conditions greatly impair activities of daily living, contribute to psychological distress, depressive symptoms, reduced body image and confidence, as well as posing a substantial economic burden on the healthcare system. Understanding the aetiology and pathogenesis of both conditions will aid in optimising function for the women affected by these conditions, and in turn, reduce the economic burden on the healthcare system.

Funding acknowledgements: Nil funding

Keywords:
Perinatal
Pelvic Organ Prolapse
Obstructed Defaecation

Topics:
Pelvic, sexual and reproductive health

Did this work require ethics approval? Yes

Institution: Mater Misericordiae Ltd

Committee: Mater Misericordiae Ltd HREC

Ethics number: HREC/MML/56778 (V4)