Subspecialty care for peripartum pelvic floor disorders

Am J Obstet Gynecol. 2020 Nov;223(5):709-714. doi: 10.1016/j.ajog.2020.08.015. Epub 2020 Sep 2.

Abstract

Obstetrical perineal and anal sphincter lacerations can be associated with considerable sequelae. The diagnosis of short-term bowel, bladder, and healing problems can be delayed if patients are not seen until the traditional postpartum visit at 4 to 6 weeks. Specialized peripartum clinics create a unique opportunity to collaborate with obstetrical specialists to provide early, individualized care for patients experiencing a variety of pelvic floor issues during pregnancy and in the postpartum period. Although implementation of these clinics requires thoughtful planning and partnering with care providers at all levels in the obstetrics care system, many of the necessary resources are available in routine gynecologic practice. Using a multidisciplinary approach with pelvic floor physical therapists, nurses, advanced practice providers, and other specialists is important for the success of this service line and enhances the level of care provided. Overall, these clinics provide a structured means by which pregnant and postpartum women with pelvic floor symptoms can receive specialized counseling and treatment.

Keywords: birth trauma; female pelvic medicine and reconstructive surgery; obstetrical anal sphincter injury; obstetrical laceration; patient education; pelvic floor disorder; pelvic floor physical therapy; peripartum.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anal Canal / injuries*
  • Delivery, Obstetric / adverse effects
  • Dyspareunia / therapy
  • Fecal Incontinence / therapy
  • Female
  • Humans
  • Lacerations / etiology
  • Lacerations / therapy*
  • Obstetrics*
  • Patient Care Team
  • Pelvic Floor / injuries
  • Pelvic Floor Disorders / etiology
  • Pelvic Floor Disorders / therapy*
  • Pelvic Organ Prolapse / therapy
  • Pelvic Pain / therapy
  • Perineum / injuries
  • Peripartum Period
  • Physical Therapy Modalities*
  • Postnatal Care / organization & administration*
  • Pregnancy
  • Prenatal Care / organization & administration*
  • Referral and Consultation
  • Urinary Incontinence / therapy