2.50
Hdl Handle:
http://hdl.handle.net/10755/158882
Type:
Presentation
Title:
Risk Factors for Muscle Changes on MRI post Vaginal Birth
Abstract:
Risk Factors for Muscle Changes on MRI post Vaginal Birth
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Low, Lisa, CNM PhD
P.I. Institution Name:Univesity of Michigan
Contact Address:400 North Ingalls, Rm 3249, Ann Arbor, MI, 48109, USA
Contact Telephone:734-647-0334
Co-Authors:L. Kane Low, R. Zielinski, J.M. Miller, Health Promotion Risk Reduction, University of Michigan, Ann Arbor , MI; R. Zielinski, Nursing, Western Michigan University, Kalamazoo, MI; J.M. Miller, Obstetrics and Gynecology, University of Michigan, Ann Arbor,
Studies find vaginal births complicated by anal sphincter tear, instrumental delivery, or long second stage are associated with levator ani muscle (LA) injury documented on magnetic resonance imaging (MRI) in primiparous women at 9 months post partum. This finding is significant as LA injury is associated with prolapse later in a woman's life. Past investigations have been limited by retrospective data collected distant from birth and low injury prevalence generally. Aims are 1) Determine prevalence of LA changes post first vaginal birth with known risk factors 2) Identify obstetrical risk factors that may contribute to muscle changes on MRI. Using previously identified risk factors for LA injury as inclusion criteria for an enriched sample of women immediately post first vaginal birth (n=19) MRIs were done 2-6 weeks postpartum and obstetrical data was abstracted from by an experienced CNM. A multiplanar intermediate-weighted sequences were done. LA defect status was graded as none, (no muscle change) minor or major changes, by a radiologist blinded to the obstetrical risks. Descriptive statistics and t-tests were done. Of 19 women, no injury was found in 10 while 9 demonstrated minor to major evidence of LA injury (53% vs. 47%). Comparison of the groups (injured to non-injured) using the recruitment risk factors, did not delineate significantly between the groups (p = .634). However, when 14 additional obstetrical risk factors were considered, there was a trend towards statistical significance between the injured and non-injured groups with the injured group having a higher mean number of risk factors compared to the non-injured group (Mean 4.0 vs. Mean 3.1 p=.08). Risk factors are listed in Table 1. Case finding for LA injury was enhanced using risk factors in prior studies; however additional risk factors indicate it's a matrix of events that result in injury compared to a single risk event. This pilot study is under powered to compare the groups, thus further studies are needed. Prevention of LA injury may be enhanced by using evidence based practices during 2nd stage labor to reduce the cascade effect of multiple events occurring that are associated with injury. Funding by NICHD R21 HD049818 and NICHD/ORWH P50 HD HD044406-05
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRisk Factors for Muscle Changes on MRI post Vaginal Birthen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158882-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Risk Factors for Muscle Changes on MRI post Vaginal Birth</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Low, Lisa, CNM PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Univesity of Michigan</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 North Ingalls, Rm 3249, Ann Arbor, MI, 48109, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-647-0334</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kanelow@umich.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L. Kane Low, R. Zielinski, J.M. Miller, Health Promotion Risk Reduction, University of Michigan, Ann Arbor , MI; R. Zielinski, Nursing, Western Michigan University, Kalamazoo, MI; J.M. Miller, Obstetrics and Gynecology, University of Michigan, Ann Arbor, </td></tr><tr><td colspan="2" class="item-abstract">Studies find vaginal births complicated by anal sphincter tear, instrumental delivery, or long second stage are associated with levator ani muscle (LA) injury documented on magnetic resonance imaging (MRI) in primiparous women at 9 months post partum. This finding is significant as LA injury is associated with prolapse later in a woman's life. Past investigations have been limited by retrospective data collected distant from birth and low injury prevalence generally. Aims are 1) Determine prevalence of LA changes post first vaginal birth with known risk factors 2) Identify obstetrical risk factors that may contribute to muscle changes on MRI. Using previously identified risk factors for LA injury as inclusion criteria for an enriched sample of women immediately post first vaginal birth (n=19) MRIs were done 2-6 weeks postpartum and obstetrical data was abstracted from by an experienced CNM. A multiplanar intermediate-weighted sequences were done. LA defect status was graded as none, (no muscle change) minor or major changes, by a radiologist blinded to the obstetrical risks. Descriptive statistics and t-tests were done. Of 19 women, no injury was found in 10 while 9 demonstrated minor to major evidence of LA injury (53% vs. 47%). Comparison of the groups (injured to non-injured) using the recruitment risk factors, did not delineate significantly between the groups (p = .634). However, when 14 additional obstetrical risk factors were considered, there was a trend towards statistical significance between the injured and non-injured groups with the injured group having a higher mean number of risk factors compared to the non-injured group (Mean 4.0 vs. Mean 3.1 p=.08). Risk factors are listed in Table 1. Case finding for LA injury was enhanced using risk factors in prior studies; however additional risk factors indicate it's a matrix of events that result in injury compared to a single risk event. This pilot study is under powered to compare the groups, thus further studies are needed. Prevention of LA injury may be enhanced by using evidence based practices during 2nd stage labor to reduce the cascade effect of multiple events occurring that are associated with injury. Funding by NICHD R21 HD049818 and NICHD/ORWH P50 HD HD044406-05</td></tr></table>en_GB
dc.date.available2011-10-26T21:29:19Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:29:19Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.