| ObjectiveTo investigate the effects of three different modes, including normal vaginal delivery(NVD), normal vaginal delivery with Episiotomy(NVD/epi), and caesarean section(C/S), on postpartum sexual function in primiparous women at the third month, sixth month and ninth month after delivery. The study involves level of sexual function, sexual dysfunction and problems, restoration of sexual life, and change of sex frequency. Try to understand status of postpartum sexual health with these three different delivery modes, to improve females' quality of life after childbirth and to provide provide clinical datas.MethodsWomen giving birth in department of gynecology and obstetrics at Second Hospital of Shandong University between January,2010 and June,2010, meeting the inclusion criteria were analyzed. The inclusion criteria included age, educational attainment, weight, having dysfunction history or not, having psychological disorders or not, and so on. The modes of delivery consisted Normal vaginal delivery (NVD), Normal vaginal delivery with episiotomy (NVD/epi), and Caesarean section (C/S). After the purpose of survey and principle of confidentiality were told,405 of them were allowed to be followed up. In this cross-sectional study, everyone was followed up by answering questionnaires respectively at the third, sixth, and the ninth month, which included basic survey, FSFI, and postpartum depression questionnaires. FSFI questionnaire conclude six dimensions, including sexual desire, sexual arousal, vagina lubrication, orgasm, sexual satisfaction and dyspareunia. We used the patterns of family visit, letters or telephone to follow up. Women who could not complete whole follow-up process were ruled out. Accrooding to the exclusion criteria which included accidents, general or gynecological diseases, pregnant again, postpartom depression, and so on, some women were ruled out. Finally, the 198 remainings were brought into this analyzation,which can be divided into three groups:NVD group(42), NVD/epi group(77), and C/S group(79). All the datas were quantificated into scores according to standard for evaluation of FSFI questionnaire, and analyzed by SPSS 16.0 system with methods of analysis of variance, non-parametric test, and SNK.95% confidence interval were calculated.Results1. Sexual function of postpartum women with different modes of delivery①In the third month after childbirth, FSFI total score of NVD/epi group was(23.23±3.19),significantly lower than NVD group and C/S group(P<0.05),of which total score was (25.64±3.91) and (25.42±2.75) separately, while no significant differece existed between NVD group and C/S group(P>0.05). The dimensions scoring of dyspareunia,vaginal lubrication,and sexual satisfaction were significant lower in NVD/epi group(P<0.05.)②In the sixth month after childbirth, FSFI total score of NVD/epi group was (26.13±2.71),and was lowest compared with NVD group and C/S group(P<0.05), whose FSFI total score of (27.34±2.50) and (27.47±2.78), while there was no significant differece existing between NVD group and C/S group(P>0.05).The dimensions scoring of orgasm, sexual satisfaction,and dyspareunia was significantly different in these three groups(P<0.05.)③In the ninth month after childbirth, FSFI total scores had no signficant difference in NVD group,NVD/epi group,and C/S group(P>0.05),which was (28.93±2.48),(28.46±2.67),and (29.17±2.59) separately. While score of dyspareunia was still significant lower in NVD/epi group (P<0.05.)2. FSD rates of postpartum women with different modes of delivery①In the third month of postpartum period, FSD rate of NVD/epi group was 68.09%, significantly higher than NVD group(41.67%) and C/S group(45.61%) (P< 0.05), while there was no significant difference between NVD group and C/S group (P>0.05).②In the sixth month of postpartum period, FSD rate of NVD/epi group was down to 46.67%,significantly higher than NVD group (26.19%) and C/S group (30.26%)(P<0.05),and no significant difference between NVD group and C/S group (P>0.05).③In the ninth month of postpartum period,FSD rates of NVD group,NVD/epi group,and C/S group were separately 14.29%,23.38%,and 18.99%,and no significant difference existed in three groups(P>0.05).3. Sex frequency of postpartum women with different modes of deliveryIn the third month after childbirth, the frequency of sexual activity was significantly differnct in NVD group, NVD/epi group and C/S group(P=0.018).While no significant difference existed in 6-9 months after childbirth.4. Restoration of sexual life of postpartum women with different modes of delivery140 (70.71%) females resumed sexual activity within 3 months after childbirth. The recovery rate of NVD/epi group was 61.04%,significantly lower than NVD group(85.71%)(P<0.05).There were no significant difference between NVD/epi group and C/S group(72.15%), NVD group and C/S group (P>0.05).ConclusionIn the third and sixth month after childbirth,the sexual function, restoration of postpartum sexual life, frequency of sexual activity,of NVD/epi group were significantly lowest,and the FSD rate was significantly higher than NVD group and C/S group. But it showed no significant difference between NVD group and C/S group in all aspects mentioned the above.Our investigation indicated that the integrity of perineum is closely related to postpartum sexual health. Female sexal function of different modes of delivery was improving gradually with the time past,while there still a considerable number of female had FSD in the ninth month. SignificanceWith social progress and raise of knowledge level, foreign scholars already took female sexual health seriously.During these years,a large number of experimental and clinical follow-up study were proceeded.While interiorly female sexual health was payed little attention because of our traditional culture. Clinical research datas was lack especially in postpartum period. Our research indicated that female sexual problems are ubiquitous after delivery.,while effects of delivery modes on postpartum sexual function are rarely considered in clinic. In the future,we should be aware of the importance female sexual health in postpartum period, strengthen the protection of the integrity of perineum, which has great significance to improve the health status, reduce the occurrence of FSD and sexual issues. |
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