Birth, Muscle Injury and Pelvic Floor Dysfunction

说明(申请人提供)：本提案旨在改善对患有盆底功能障碍等优先健康状况的妇女的护理；这些问题是由于妇女在生育方面的独特作用而产生的。它解决了这些问题中存在的性别差异。每年有300万妇女分娩，30万妇女因盆底功能障碍而需要手术。对生育年中与出生有关的伤害和康复机制以及晚年脱垂机制缺乏基本了解，阻碍了预防损害、改善康复或改善治疗的努力。我们寻求继续支持来自4所学校和2个研究所的广泛的跨学科研究人员小组，以促进改进治疗和预防所需的新知识的发展。项目1：“分娩生物力学”将测试有关阴道分娩期间盆底损伤的基本机制的假设；导致盆底功能障碍的单个最大因素确定具体情况可能会增加或降低受伤风险。项目2：“损伤恢复”将确定与提升肌损伤相关的风险因素，检验这些损伤实际上与阴道分娩有关的假设，并确定最终恢复的早期预测因素。项目3，“阴道后壁脱垂的机制”将使用先进的成像和变形分析来测试有关阴道后壁脱垂的基本疾病机制的假说，阴道后壁脱垂是最常见和强烈的出生相关盆底功能障碍之一。核心A：行政/人类科目/生物统计学核心通过招募受试者、汇编和分析数据以及保护受试者安全来提供项目支持。在核心A中，将组成两个研究小组，讨论1)性别影响和2)基础科学未来，以讨论扩大这项研究提出的问题。核心B：测量和成像核心将为项目提供技术支持，以及对跨项目收集的2维和3维空间数据进行综合分析。这项研究将为解决女性盆底功能障碍的健康问题提供见解

DESCRIPTION (provided by applicant): This proposal seeks to improve care for the women who suffer the priority health conditions of pelvic floor dysfunction; problems that arise due to women's unique role in giving birth. It addresses the sex disparities that exist in these problems. Each year 3 million women deliver babies and 300,000 women need surgery for pelvic floor dysfunction. A lack of basic understanding of the mechanisms of birth-related injury and recovery during reproductive years and mechanisms of prolapse later in life block efforts to prevent damage, improve recovery, or improve treatment. We seek continued support for a broadly interdisciplinary group of researchers from 4 schools and 2 institutes to that has expedited development of new knowledge needed to improve treatment and prevention. Project 1: "Birth Biomechanics" will test hypotheses concerning basic mechanisms of pelvic floor injury during vaginal birth; the single largest factor in causing pelvic floor dysfunction to identify specific situations may increase or decrease injury risk. Project 2: "Injury Recovery" will identify risk factors associated with levator injury, test the hypothesis that these injuries are, in fact, related to vaginal delivery and determine early predictors of eventual recovery. Project 3, "Mechanisms of Posterior Vaginal Prolapse" will use advanced imaging and deformation analysis to test hypotheses concerning the basic disease mechanisms responsible for posterior vaginal wall prolapse, one of the most common and strongly birth-associated pelvic floor dysfunction. Core A: Administrative / Human Subjects / Biostatistics core provides project support by recruiting subjects, compiling and analyzing data and protecting subject safety. In Core A, two study groups will be formed concerning 1) Gender Impact and 2) Basic Science Futures to discuss expanding the issues raised by this research. Core B: Measurement and Imaging core will provide technical support for the projects along with integrated analysis for 2 and 3 dimensional spatial data gathered across projects. This research will produce insights to address the women's health problem of pelvic floor dysfunction