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Tedavi sonrası vajinismus hastalarının gebelik sonuçları, obstetrik ve perinatal sonuçlarının değerlendirilmesi

Yıl 2021, Cilt: 18 Sayı: 4, 1023 - 1027, 31.12.2021
https://doi.org/10.38136/jgon.943264

Öz

Amaç: Bu çalışmanın amacı; vajinismus tedavisi sonrası spontan gebe kalabilmiş primer vajinismus hastalarının obstetrik ve perinatal sonuçlarını irdeleyerek, tedavi edilmiş primer vajinismusun obstetrik ve perinatal komplikasyonlar için halen bir risk faktörü olup olmadığını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya, 1 Ocak 2018-1 Ağustos 2020 tarihleri arasında, 8 haftayı geçmemiş gebeliği bulunan, 18-35 yaş arasında, daha önceden primer vajinismus tedavisi almış, nullipar, spontan gebe kalmış 50 hasta dahil edildi. Kontrol grubunda ise 56 nullipar gebe bulunmaktaydı. Hastaların dosyaları retrospektif taranarak, demografik verileri, karakteristik özellikleri, doğum haftaları, doğum indüksiyonu gerekliliği, doğum şekilleri, sezaryen endikasyonları, fetüslerin doğum kiloları, apgar skorları ve yenidoğan yoğun bakım ünitesi ihtiyaçları kaydedildi ve gruplar arasında karşılaştırıldı.
Bulgular: Vajinismus grubunda 31 (%68.9) hasta, kontrol gurunda ise 16 (%31.4) hasta sezaryen doğum yaptı(p<0.01). Vaginal doğum yapan hastalar arasında, vajinismus grubunda 14 hastanın 1’i, kontrol grubunda ise 35 gebenin 2’si epizyotomisiz doğum yaptı(p=0.6). Vajinismus grubunda en sık görülen sezaryen endikasyonları; vaginal muayede güçlük ve hasta isteğiydi, kontrol grubu ile fark istatistiksel olarak anlamlıydı(sırasıyla, p=0.04, p= 0.03).
Sonuç: Tedavi sonrası spontan gebe kalan vaginismus hastalarında vaginismus öyküsü sezaryen için risk faktörüdür. Bu hastalar tedavi almış olmalarına rağmen, doğumu yaptıran obstetrik ekibin hastanın vaginal muayeneye uyum göstermede güçlük çekebileceğini ve bu hastaların sezaryen beklentisinin fazla olabileceğini bilmeleri önemlidir.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Kaynakça

  • Basson R , Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Definitions of women's sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynaecol 2003 Dec;24(4):221-9.
  • Sims MJ. On Vaginismus. Trans Obstet Soc London 1861;3:356– 67.
  • American Psychiatric Association. Diagnostic criteria from DSMIV-TR. American Psychiatric Publications; 2000.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publications; 2013.
  • Stanley E. Vaginismus. BMJ 1981;282:1435–1437.
  • Crowley T, Richardson D, Goldmeier D. Recommendations for the management of vaginismus: BASHH Special Interest Group for Sexual Dysfunction. Int J STD AIDS 2006;17:14– 18.
  • Konkan R, Bayrak M, Gonullu GO, Senormanci O, Sungur MZ. Sexual function and satisfaction of women with vaginismus. J Psychiatry Neurol Sci. 2012;25:305–311.
  • Achour R, Koch M, Zgueb Y, Ouali U, Ben Hmid R. Vaginismus and pregnancy: epidemiological profile and management difficulties. Psychol Res Behav Manag. 2019 Mar 12;12:137-143.
  • Melnik T, Hawton K, McGuire H. Interventions for vaginismus. Cochrane Database Syst Rev. 2012 Dec 12;12(12):CD001760. doi: 10.1002/14651858.CD001760.pub2.
  • Pacik PT, Geletta S. Vaginismus Treatment: Clinical Trials Follow Up 241 Patients. Sex Med. 2017 Jun;5(2):e114-e123.
  • Berger MH, Messore M, Pastuszak AW, Ramasamy R. Association Between Infertility and Sexual Dysfunction in Men and Women. Sex Med Rev. 2016 Oct;4(4):353-365.
  • Souza MDCB, Gusmão MCG, Antunes RA, Souza MM, Rito ALS, Lira P, Mancebo ACA, Tamm MA, Panaino TR, Bahia MJ. Vaginismus in Assisted Reproductive Technology Centers: an invisible population in need of care. JBRA Assist Reprod. 2018 Mar 1;22(1):35-41.
  • Tourrilhes E, Veluire M, Hervé D, Nohuz E. Pronostic obstétrical des femmes atteintes de vaginisme primaire [Obstetric outcome of women with primary vaginismus]. Pan Afr Med J. 2019 Apr 8;32:160. French.
  • Goldsmith T, Levy A, Sheiner E, Goldsmith T, Levy A, Sheiner E. Vaginismus as an independent risk factor for cesarean delivery. J Matern Fetal Neonatal Med. 2009 Oct;22(10):863-6.
  • Möller L, Josefsson A, Bladh M, Lilliecreutz C, Sydsjö G. Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study. BJOG. 2015 Feb;122(3):329-34.
  • Özdel K, Yılmaz Özpolat A, Çeri Ö, Kumbasar H. Factors that might be predictive of completion of vajinismus treatment. Turk Psikiyatri Derg. 2012 Winter;23(4):248-53.
  • Drenth JJ, Andriessen S, Heringa MP, Mourits MJ, van de Wiel HB, Weijmar Schultz WC. Connections between primary vajinismus and procreation: some observations from clinical practice. J Psychosom Obstet Gynaecol. 1996 Dec;17(4):195-201.
  • Rosenbaum TY, Padoa A. Managing pregnancy and delivery in women with sexual pain disorders. J Sex Med. 2012 Jul;9(7):1726-35; quiz 1736.
  • Quiret-Rousselle B. Vaginisme et grossesse: une meilleure compréhension pour une prise en charge adaptée. Vocation sage-femme. 2012;11(99):14–8.

Examination of pregnancy outcomes, obstetric and perinatal outcomes of vaginismus patients after treatment

Yıl 2021, Cilt: 18 Sayı: 4, 1023 - 1027, 31.12.2021
https://doi.org/10.38136/jgon.943264

Öz

Aim: The aim of this study is; to evaluate whether treated primary vaginismus (PV) is still a risk factor for obstetric&perinatal complications by examining the obstetric&perinatal outcomes of PV patients who could conceive spontaneously after vaginismus treatment.
Materials and Methods: Fifty nulliparous and spontaneous pregnancies between the ages of 18-35, who had previously received PV treatment between January 1, 2018 and August 1, 2020, were included in the study. There were 56 nulliparous pregnant women in the control group. The patients' files were scanned retrospectively, and their demographic data, characteristics, delivery weeks, labor induction requirement, delivery types, cesarean indications, birth weights of fetuses, apgar scores and neonatal intensive care unit needs were recorded and compared between the groups.
Results: Caesarean delivery was performed by 31 patients (68.9%) in the vaginismus-group and 16 (31.4%) patients in the control-group (p<0.01). Among the patients who delivered vaginally, 1 of 14 patients in the vaginismus-group and 2 of 35 patients in the control-group gave birth without episiotomy (p=0.6). The most common cesarean indications in the vaginismus-group are; the difficulty in vaginal examination, and the patient's request, the difference in the control-group was statistically significant (p=0.04, p=0.03, respectively).
Conclusion: In PV patients who conceive spontaneously after treatment, the history of vaginismus is a risk factor for cesarean delivery. Although these patients have received treatment, it is important for the obstetric team to know that the patient may have difficulty in adapting to the vaginal examination and that these patients may have a high expectation of cesarean section.

Proje Numarası

yok

Kaynakça

  • Basson R , Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Definitions of women's sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynaecol 2003 Dec;24(4):221-9.
  • Sims MJ. On Vaginismus. Trans Obstet Soc London 1861;3:356– 67.
  • American Psychiatric Association. Diagnostic criteria from DSMIV-TR. American Psychiatric Publications; 2000.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publications; 2013.
  • Stanley E. Vaginismus. BMJ 1981;282:1435–1437.
  • Crowley T, Richardson D, Goldmeier D. Recommendations for the management of vaginismus: BASHH Special Interest Group for Sexual Dysfunction. Int J STD AIDS 2006;17:14– 18.
  • Konkan R, Bayrak M, Gonullu GO, Senormanci O, Sungur MZ. Sexual function and satisfaction of women with vaginismus. J Psychiatry Neurol Sci. 2012;25:305–311.
  • Achour R, Koch M, Zgueb Y, Ouali U, Ben Hmid R. Vaginismus and pregnancy: epidemiological profile and management difficulties. Psychol Res Behav Manag. 2019 Mar 12;12:137-143.
  • Melnik T, Hawton K, McGuire H. Interventions for vaginismus. Cochrane Database Syst Rev. 2012 Dec 12;12(12):CD001760. doi: 10.1002/14651858.CD001760.pub2.
  • Pacik PT, Geletta S. Vaginismus Treatment: Clinical Trials Follow Up 241 Patients. Sex Med. 2017 Jun;5(2):e114-e123.
  • Berger MH, Messore M, Pastuszak AW, Ramasamy R. Association Between Infertility and Sexual Dysfunction in Men and Women. Sex Med Rev. 2016 Oct;4(4):353-365.
  • Souza MDCB, Gusmão MCG, Antunes RA, Souza MM, Rito ALS, Lira P, Mancebo ACA, Tamm MA, Panaino TR, Bahia MJ. Vaginismus in Assisted Reproductive Technology Centers: an invisible population in need of care. JBRA Assist Reprod. 2018 Mar 1;22(1):35-41.
  • Tourrilhes E, Veluire M, Hervé D, Nohuz E. Pronostic obstétrical des femmes atteintes de vaginisme primaire [Obstetric outcome of women with primary vaginismus]. Pan Afr Med J. 2019 Apr 8;32:160. French.
  • Goldsmith T, Levy A, Sheiner E, Goldsmith T, Levy A, Sheiner E. Vaginismus as an independent risk factor for cesarean delivery. J Matern Fetal Neonatal Med. 2009 Oct;22(10):863-6.
  • Möller L, Josefsson A, Bladh M, Lilliecreutz C, Sydsjö G. Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study. BJOG. 2015 Feb;122(3):329-34.
  • Özdel K, Yılmaz Özpolat A, Çeri Ö, Kumbasar H. Factors that might be predictive of completion of vajinismus treatment. Turk Psikiyatri Derg. 2012 Winter;23(4):248-53.
  • Drenth JJ, Andriessen S, Heringa MP, Mourits MJ, van de Wiel HB, Weijmar Schultz WC. Connections between primary vajinismus and procreation: some observations from clinical practice. J Psychosom Obstet Gynaecol. 1996 Dec;17(4):195-201.
  • Rosenbaum TY, Padoa A. Managing pregnancy and delivery in women with sexual pain disorders. J Sex Med. 2012 Jul;9(7):1726-35; quiz 1736.
  • Quiret-Rousselle B. Vaginisme et grossesse: une meilleure compréhension pour une prise en charge adaptée. Vocation sage-femme. 2012;11(99):14–8.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makaleleri
Yazarlar

Tunay Kiremitli 0000-0002-4531-827X

Sevil Kiremitli 0000-0002-2545-416X

Proje Numarası yok
Yayımlanma Tarihi 31 Aralık 2021
Gönderilme Tarihi 26 Mayıs 2021
Kabul Tarihi 11 Ekim 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 4

Kaynak Göster

Vancouver Kiremitli T, Kiremitli S. Tedavi sonrası vajinismus hastalarının gebelik sonuçları, obstetrik ve perinatal sonuçlarının değerlendirilmesi. JGON. 2021;18(4):1023-7.