Intra-abdominal pressure and postpartum pelvic floor support and symptoms

项目概要/摘要-项目1 四分之一的女性患有某种类型的骨盆底疾病的中度至重度症状， 在她有生之年接受手术治疗阴道产次、盆腔器官 脱垂和骨盆底症状是公认的;对于许多妇女来说，未来的骨盆底阶段 在第一次阴道分娩时，我们就开始了疾病，但我们对如何在这之后最大限度地恢复知之甚少。 开创性的事件这一知识差距限制了为防止恶化而制定改变风险的战略 骨盆底支撑和阴道分娩后的症状。进一步的研究，提供了深入了解 需要最早的发病过程。 腹内压（IAP），项目1的重点，是一个直接的措施所经历的力量， 骨盆底，但很少研究，除了在有限的临床设置。我们小组已经开发并测试了 一种新型的阴道内传感器，可以测量IAP并将数据无线传输到一个小型的寻呼机式数据采集器。 存储设备。在这个项目中，我们计划使用这个系统来研究IAP如何影响两个主要结果， 产后1年：1）盆底支持和2）盆底症状。 这一项目的范围与国家排雷中心所述的使命有关，即确保“妇女不遭受任何有害的暴力侵害， 生殖过程的影响”，并特别针对骨盆底疾病， 妇科健康和疾病分支的组合。本项目将使用初产队列 由临床协调中心建立，以实现这些目标： 目的1：确定是否在产后8周在a）举重和B）腹肌期间测量IAP 耐力测试预测产后1年的骨盆底支撑和症状。 目的2：确定在产后6个月的日常生活中测量一周的IAP是否预测骨盆 产后1年的地板支撑和症状。 探索性目标3：确定肌肉健康的措施是否会改变举重过程中IAP对 产后1年时的骨盆底支撑。 转化目标：使用本项目目标2和项目2的数据，其中测量身体活动 在产后6个月使用加速度计进行7天的测量，探索数据之间的关系， 从阴道压力传感器和腕戴式加速度计获得。

Project Summary/Abstract – Project 1 One in four women has moderate to severe symptoms of some type of pelvic floor disorder and up to 1 in 7 undergo surgery for these conditions in her lifetime. Associations between vaginal parity, pelvic organ prolapse and pelvic floor symptoms are well established; for many women, the stage for future pelvic floor disorders is set with the first vaginal delivery, yet we know little about how to maximize recovery following this seminal event. This knowledge gap limits developing strategies to modify risks in order to prevent deterioration of pelvic floor support and symptoms after vaginal delivery. Further research that provides insight into the earliest onset of the pathogenic process is needed. Intra-abdominal pressure (IAP), the focus of Project 1, is a direct measure of the forces experienced by the pelvic floor but has rarely been studied except in limited clinical settings. Our group has developed and tested a novel intra-vaginal transducer that measures IAP and wirelessly transmits the data to a small, pager-like data storage device. In this project, we plan to use this system to study how IAP impacts two primary outcomes at 1 year postpartum: 1) pelvic floor support and 2) pelvic floor symptoms. The scope of this project is relevant to NICHD's described mission, to ensure that “women suffer no harmful effects from reproductive processes”, and specifically addresses pelvic floor disorders, as emphasized in the portfolio of the Gynecologic Health and Disease Branch. This project will use the Primiparous Cohort established by the Clinical Coordination Core to achieve these aims: Aim 1: Determine whether IAP measured at 8 weeks postpartum during a) lifting and b) abdominal muscle endurance testing predicts pelvic floor support and symptoms 1 year postpartum. Aim 2: Determine whether IAP measured for one week during daily life at 6 months postpartum predicts pelvic floor support and symptoms 1 year postpartum. Exploratory Aim 3: Determine whether measures of muscular fitness modify the effect of IAP during lifting on pelvic floor support at 1 year postpartum. Translational aim: Using data from Aim 2 of this Project and Project 2, in which physical activity is measured using accelerometry for a 7 day period at 6 months postpartum, explore the relationships between data obtained from the vaginal pressure sensor and wrist-worn accelerometry.