Background: Pelvic floor dysfunction (PFD) and associated pain are common in parous women. Many retrospective studies have found risks associated with PFD including, stress urinary incontinence, large fetal head circumference, large fetal weight at delivery, vacuum extraction, connective tissue deficiencies, vaginal delivery, etc. Many experience other symptoms such as pain on defecation, organ prolapse, rectal bleeding, and sexual dysfunction postpartum (PP), some of which may be treated with physical therapy (PT). Few studies prospectively evaluate PT PP patients, and few retrospective studies have patients with more than one PT visit after 6 weeks PP. There is little to no data reported on outcomes of PFD patients within the first 6 months of recovery PP. A recent meta-analysis agrees, suggesting that little research has been dedicated to analyzing the effects of exercise PP.
Methods: After IRB approval, we worked with Health Data Compass to pull data of potential subjects. Data was pulled from Oct 2019 through May 2023 of women who had delivered in a hospital setting with 12 different providers. These providers practice at UCHealth’s Highlands Ranch Hospital or Lone Tree Clinic. Over 1,000 patients were identified. This project aims to address multiple research questions, thus multiple data points were collected. For the purposes of this project, patients were filtered down to those who have then also been seen by UCHealth’s Steadman Hawkins and Lone Tree Clinics by one of six pelvic floor physical therapists (PFPT). Subjects who have also completed the patient reported outcome measure - the pelvic floor distress inventory (PFDI-20) - within a year of delivery, were included. 89 subjects were isolated. All include at least one pelvic floor diagnosis and one delivery.
Conclusions: A significant portion of individuals diagnosed during pregnancy or pre-partum did not receive care from a PFPT. We are unable to provide an exact percentage due to inconsistencies in the completion of the PFDI20, but we estimate that approximately 10% of those in need of treatment were treated. The three most common diagnoses were second-degree perineal lacerations during delivery, pelvic and perineal pain, and first-degree lacerations. Among those with available PFDI scores, four had the same diagnosis for their subsequent deliveries, 25 had multiple diagnoses, and six had different diagnoses for each delivery. The remaining 54 subjects had at least one diagnosis before or during their delivery. 68% of subjects received treatment from a PFPT 42 days or more after their diagnosis. While this sample is representative of the areas we serve, further analysis is required before drawing any definitive conclusions.
Methods: After IRB approval, we worked with Health Data Compass to pull data of potential subjects. Data was pulled from Oct 2019 through May 2023 of women who had delivered in a hospital setting with 12 different providers. These providers practice at UCHealth’s Highlands Ranch Hospital or Lone Tree Clinic. Over 1,000 patients were identified. This project aims to address multiple research questions, thus multiple data points were collected. For the purposes of this project, patients were filtered down to those who have then also been seen by UCHealth’s Steadman Hawkins and Lone Tree Clinics by one of six pelvic floor physical therapists (PFPT). Subjects who have also completed the patient reported outcome measure - the pelvic floor distress inventory (PFDI-20) - within a year of delivery, were included. 89 subjects were isolated. All include at least one pelvic floor diagnosis and one delivery.
Conclusions: A significant portion of individuals diagnosed during pregnancy or pre-partum did not receive care from a PFPT. We are unable to provide an exact percentage due to inconsistencies in the completion of the PFDI20, but we estimate that approximately 10% of those in need of treatment were treated. The three most common diagnoses were second-degree perineal lacerations during delivery, pelvic and perineal pain, and first-degree lacerations. Among those with available PFDI scores, four had the same diagnosis for their subsequent deliveries, 25 had multiple diagnoses, and six had different diagnoses for each delivery. The remaining 54 subjects had at least one diagnosis before or during their delivery. 68% of subjects received treatment from a PFPT 42 days or more after their diagnosis. While this sample is representative of the areas we serve, further analysis is required before drawing any definitive conclusions.