Assessment of post-partum women's knowledge about obstetric pelvic floor disorders

billecocq s1, Busche H2, Eboué F1

Research Type

Clinical

Abstract Category

Pregnancy and Pelvic Floor Disorders

Abstract 756
Open Discussion ePosters
Scientific Open Discussion Session 108
Friday 25th October 2024
13:05 - 13:10 (ePoster Station 3)
Exhibition Hall
Prevention Pelvic Floor Incontinence Pelvic Organ Prolapse Pain, Pelvic/Perineal
1. Hôpital Paris Saint Joseph, 2. centre hospitalier universitaire de Nîmes
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Poster

Abstract

Hypothesis / aims of study
A recent study showed that perinatal women's knowledge of obstetric pelvic floor disorders (PFDs), their risk factors and preventive measures is limited [1,2], suggesting that they are unable to take care of themselves and are fatalistic when faced with their symptoms [1]. Furthermore, adherence to preventive measures is dependent on knowledge of obstetric PFDs. None studies addressed, in their questionnaires, all of the different themes of information on obstetric PFDs. 
Our first aim was to study the knowledge of postpartum women in an obstetric department about obstetric PFDs, taking into account the anatomy and function of pelvic floor muscles, obstetric PFDs, the means of preventing or treating them.
Our secondary aims were to study whether the desire for information varies according to the presence of some obstetric PFD’s symptoms, to describe the topics relating to obstetric PFDs discussed by healthcare professionals during pregnancy, to determine the sources and format of the information received during pregnancy.
Study design, materials and methods
This study was a prospective, monocentric cohort survey of 251 adult women whose infants were in good health and were recruited during their stay in the maternity suite between June 2021 and June 2022.
Data were collected using a self-administered questionnaire specific to the study, inspired by the validated PIKQ questionnaire and questionnaires found in the literature. The questionnaire was reread, reviewed and discussed by a multidisciplinary pelvi-perineology team and tested on 10 participants. The final questionnaire comprises of 5 sections ie, "Your knowledge", "Information and pregnancies", "Your sources of information", "Current symptoms", and "Desired format". 
The presence of symptoms was collected using data from the department follow up.  The knowledge score was determined by the number of correct answers obtained, 1 point per correct answer, 0 for wrong answers and 0.5 for "I don't know", giving a score out of 21. 
The "I don't know" answers were counted along with the "wrong" answers, for certain questions when their number was less than 4%.
For the information score, the score was determined from the 2 questions "On which topics would you have liked more information during your pregnancy?" and "Please tell us if, for the following topics, you looked for information by yourself", giving a total score out of 14. 
A comparison was made between symptomatic and non-symptomatic women to determine whether having symptoms led to a greater desire for information.
Results
In total, the women had an overall knowledge score of 14.25 out of 21, which can be considered satisfactory. The questions that elicited the most "I don't know" responses from the women were: "There is no treatment for anal incontinence (AI)", for 45.02% of them; "Can pelvic floor rehabilitation be offered during pregnancy to patients with incontinence (urinary (IU) or IA)?" for 44.22%; "Is it possible to have anal incontinence following a perineal tear? "(40.24%); "There is no treatment for prolapse" (31.87%); "Is it possible to have prolapse following childbirth" (25.90%); "It is possible to have anal incontinence following pregnancy and childbirth" (25.50%); and finally, "It is possible to have pain during sexual intercourse after childbirth" (25.50%).
Although the knowledge score was satisfactory, some questions elicited a high rate of incorrect answers: "Is pelvic floor rehabilitation systematic in the post-partum period? 46.22% answered "TRUE"; "Pelvic floor muscle exercise can reduce the risk of urinary incontinence" 35.49% of women answered "FALSE"; "How many orifices does the female pelvic floor have? "33.74% of women answered 2 holes; "Watching your weight during pregnancy can reduce the risk of urinary incontinence", 29.48% of women answered "FALSE"; finally, to the question "It is possible to have pain around the genital area after giving birth", 25.50% of women answered "FALSE".
Comparing the group of symptomatic women (n= 139) with the group of non-symptomatic women (n= 112), the knowledge scores were the same (14.37 vs 14.09).
The participants' total information score was 5.18 out of 14, which can be considered unsatisfactory. 79.58% of women had not received information on pelvic floor pain, 74.10% on risk factors for obstetric PFD’s, 70.92% on prevention of them, 70.52% on pain during intercourse, 64.54% on perineal floor anatomy, 60.56% on prolapse, 60.16% on AI, 54.98% on constipation and 49% on UI .
However, 72.51% of women did not seek information on risk factors for obstetric PFDs, 70.92% on pelvic floor pain, 69.72% on preventing obstetric PFDs, 69.32% on pelvic floor anatomy, 68.13% on prolapse, 67.33% on IA, 66.93% on constipation, 65.74% on pain during intercourse and 63.65% on bladder weakness.
Information on IU was the most frequently received information during pregnancy and the most sought-after topic, whereas risk factors for obstetric PFDs were the least sought-after.
Women gave a high level of importance to all the themes, from 96% to 98%, with prolapse and pelvic floor pain having the highest levels.
No link was established between being symptomatic and the desire for information on the various topics presented. Asymptomatic women were just as keen to obtain information as symptomatic women.
For information on the anatomy of the pelvic floor, muscles, the main source of information was the midwife (38.65%), with other professionals coming 6th after the general public (physiotherapist 22.71%, gynaecologist 20.32% and general practitioner 17.13%).
For obstetric pelvic floor symptoms, the primary source of information was the family (31.47%), followed by the midwife (4th), the physiotherapist (7th) (19.92%),  the gynaecologist (8th)  .
For the topic on prevention and risk factors for obstetric PFDs, the health professionals who provided the information were the midwife (31.73%), the GP (30.68%), the gynaecologist and the physiotherapist (25.90%). 
The topics on which women wanted the most information were obstetric pelvic floor symptoms, how to manage them and how to limit them. Most of them wanted to be informed at the start of their pregnancy, using an app and by a healthcare professional in a group or individually.
Interpretation of results
The results showed similarities with the data in the literature for knowledge of PPDs [2], the link between overweight and pelvic-perineal disorders [2], the benefits of physical activity during pregnancy [3] and the different treatments that may exist for the various obstetric PFDs [2]. No link was found between the presence of UI and the desire to be informed about this disorder. Women want to be informed about preventative measures for obstetric PFDs and to have more information about these disorders. This is consistent with the literature.
Concluding message
The level of knowledge about obstetric PFDs was satisfactory. However, women's education about the risk factors and the preventative measures for the occurrence obstetric PFDs was incomplete. Health professionals were a poor source of information; only the midwife was identified as such. Women had little knowledge of treatments and did not identify the healthcare professionals who were able to treat them.
References
  1. O’Neil AT, Hockey J, O’Brien P, et al. Knowledge of pelvic floor problems: a study of third trimester, primiparous women. Int Urogynecol J. 2017;28:125–9.
  2. McLennan MT, Melick CF, Alten B, Young J, Hoehn MR. Patients’ knowledge of potential pelvic floor changes associated with pregnancy and delivery. Int Urogynecol J Pelvic Floor Dysfunct 2006;17:22–6. https://doi.org/10.1007/s00192-005-1325-2
  3. Davenport MH, Ruchat S-M, Sobierajski F, Poitras VJ, Gray CE, Yoo C, et al. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis. Br J Sports Med. janv 2019;53(2):99-107.
Disclosures
Funding I have no disclosure Clinical Trial Yes Registration Number Health data hub, N° F20210628110411 RCT No Subjects Human Ethics Committee Groupe Ethique Recherche Médicale Numéro IRB 00012157, n°398 Helsinki Yes Informed Consent Yes
25/06/2025 23:41:54