Birth, Muscle Injury and Pelvic Floor Dysfunction

描述（由申请人提供）：本提案旨在改善对盆底功能障碍优先健康状况的妇女的护理；由于妇女在分娩中的独特作用而产生的问题。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需要手术。缺乏对生育期间出生相关损伤和恢复机制以及生命后期脱垂机制的基本了解，阻碍了预防损伤、改善恢复或改善治疗的努力。我们寻求继续支持一个由来自4所学校和2个研究所的广泛跨学科研究人员组成的小组，该小组加快了改善治疗和预防所需新知识的开发。项目一：“分娩生物力学”将检验关于阴道分娩时盆底损伤基本机制的假设；导致盆底功能障碍的最大因素是确定具体情况可能增加或减少损伤风险。项目2：“损伤恢复”将确定与提肛肌损伤相关的风险因素，测试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检验关于阴道后壁脱垂的基本疾病机制的假设，阴道后壁脱垂是最常见和与出生密切相关的盆底功能障碍之一。核心A：行政/人类受试者/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为项目提供支持。在核心A中，将形成两个研究小组，分别涉及1)性别影响和2)基础科学未来，以讨论扩大本研究提出的问题。核心B：测量和成像核心将为项目提供技术支持，并对项目收集的二维和三维空间数据进行综合分析。这项研究将产生见解，以解决妇女盆底功能障碍的健康问题

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