Dispareunia en mujeres después de parto vaginal. Prevalencia en dos clínicas de Armenia, Colombia, 2012-2017

Contenido principal del artículo

Franklin J. Espitia-De La Hoz
http://orcid.org/0000-0002-4581-9680

Resumen

Se realizó un estudio de corte transversal que tuvo como objetivo determinar la prevalencia de la dispareunia en mujeres con parto vaginal, evaluar posibles factores de riesgo y la asociación con la episiotomía. Ingresaron mujeres atendidas por parto vaginal entre 2012 y 2017 en dos clínicas de alta complejidad en Armenia (Colombia). Se utilizó el cuestionario Índice de Función Sexual Femenina (IFFS-6) para evaluar la función sexual. Los resultados reportan una prevalencia de dispareunia del 59,37%, siendo más prevalente en mujeres sometidas a episiotomía (OR: 68,17; IC95 %: 60,57-79,15). Respecto a la asociación de la episiotomía con la presencia de dispareunia se encontró asociación significativa con la episiotomía medio-lateral (OR: 8,17; IC95%: 2,15-56,32), lesión del esfínter (OR: 7,32; IC95%: 4,86-12,75) y dehiscencia de la sutura (OR: 6,48; IC95%: 4,92-14,28). Se observaron como factores de riesgo: antecedente de endometriosis (OR: 11,6; IC95 %: 9,15-17,52), dolor pélvico crónico (OR: 3,56; IC95%: 2,21–6,32) e ITS (OR: 2,67; IC95%: 1,54–5,14), p=0,003). Se concluye que la prevalencia de dispareunia en mujeres con parto vaginal, atendidas en Armenia, varía en función de la realización de episiotomía, asociándose tanto a las complicaciones de esta como a otros antecedentes.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Cómo citar
Espitia-De La Hoz, F. J. . (2021). Dispareunia en mujeres después de parto vaginal. Prevalencia en dos clínicas de Armenia, Colombia, 2012-2017. Duazary, 18(1), 32–44. https://doi.org/10.21676/2389783X.3887
Sección
Artículo de investigación científica y tecnológica

Citas

Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kingsberg SA, Lee J. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Int Urogynecol J. 2018; 29(5):647-66. Doi: https://doi.org/10.1007/s00192-018-3603-9

Orr N, Wahl K, Joannou A, Hartmann D, Valle L, Yong P, et al. Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities. Sex Med Rev. 2018; 8(1):3-17. Doi: https://doi.org/10.1016/j.sxmr

Kumar K, Robertson D. Superficial dyspareunia. CMAJ. 2017; 189(24):E836. Doi: https://doi.org/10.1503/cmaj.161337

Polland AR, Davis M, Zeymo A, Iglesia CB. Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int Urogynecol J. 2019; 30(3):377-83. Doi: https://doi.org/10.1007/s00192-018-3739-7

Wolpe RE, Zomkowski K, Silva FP, Queiroz APA, Sperandio FF. Prevalence of female sexual dysfunction in Brazil: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2017; 211:26-32. Doi: https://doi.org/10.1016/j.ejogrb.2017.01.018

Gutzeit O, Levy G, Lowenstein L. Postpartum Female Sexual Function: Risk Factors for Postpartum Sexual Dysfunction. Sex Med. 2020; 8(1):8-13. Doi: https://doi.org/10.1016/j.esxm.2019.10.005.

Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, Bárcenas Taland I, Chiclana Actis C. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev. 2020; 8(1):38-47. Doi: https://doi.org/10.1016/j.sxmr.2019.07.002

Signorello LB, Harlow BL, Chekos AK, Repke JT. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol. 2001; 184(5):881-8; discussion 888-90. Doi: http://dx.doi.org/10.1067/mob.2001.113855

McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: a prospective cohort study. BJOG. 2015; 122(5):672-9. Doi: http://dx.doi.org/10.1111/1471-0528.13263

Leeman LM, Rogers RG. Sex after childbirth: postpartum sexual function. Obstet Gynecol. 2012; 119(3):647-55. Doi: http://dx.doi.org/10.1097/AOG.0b013e3182479611

Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD000081. Doi: http://dx.doi.org/10.1002/14651858.CD000081.pub3

Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD000081. Doi: http://dx.doi.org/10.1002/14651858.CD000081.pub2

Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Obstet Gynecol. 2018; 132(3):e87-e102. Doi: http://dx.doi.org/10.1097/AOG.0000000000002841

Muraca GM, Liu S, Sabr Y, Lisonkova S, Skoll A, Brant R, et al. Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study. CMAJ. 2019; 191(42):E1149-E1158. Doi: https://doi.org/10.1503/cmaj.190366

Manresa M, Pereda A, Goberna-Tricas J, Webb SS, Terre-Rull C, Bataller E. Postpartum perineal pain and dyspareunia related to each superficial perineal muscle injury: a cohort study. Int Urogynecol J. 2020. Doi: http://dx.doi.org/10.1007/s00192-020-04317-1

Marques Nascimento Silva A, Marques dos Santos L, Anny Costa Cerqueira E, Souza de Santana E, Carvalho, Silva Gomes Xavier A. Characterization of pain resulting from perineal trauma in women with vaginal delivery. Br J Pain. São Paulo. 2018; 1(2):158-62. Doi: https://doi.org/10.5935/2595-0118.20180030

Isidori AM, Pozza C, Esposito K, Giugliano D, Morano S, Vignozzi L, et al. Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med. 2010; 7(3):1139-46. Doi: http://dx.doi.org/10.1111/j.1743-6109.2009.01635.x

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2):191-208. Doi: http://dx.doi.org/10.1080/009262300278597

Grudzinskas JG, Atkinson L. Sexual function during the puerperium. Arch Sex Behav. 1984; 13(1):85-91. Doi: http://dx.doi.org/10.1007/BF01542980.

Connolly A, Thorp J, Pahel L. Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 16(4):263-7. Doi: http://dx.doi.org/10.1007/s00192-005-1293-6

Abd. Alkareem I, Ounsa M, Mohamed E, Mohamed E, Abdalla S. Prevalence and risk factors of postpartum dyspareunia at three months post- delivery in Sudanese women. Int J Reprod Contracept Obstet Gynecol. 2017; 6(7):2724-8. Doi: http://dx.doi.org/10.18203/2320-1770.ijrcog20172901

Lagaert L, Weyers S, Van Kerrebroeck H, Elaut E. Postpartum dyspareunia and sexual functioning: a prospective cohort study. Eur J Contracept Reprod Health Care. 2017; 22(3):200-6. Doi: http://dx.doi.org/10.1080/13625187.2017.1315938

McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: a prospective cohort study. BJOG. 2015; 122(5):672-9. Doi: http://dx.doi.org/10.1111/1471-0528.13263

Fahmy MM, Al-Lakwa HE, Al-Halaby AE, Al-Sharkawy EA. Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery. Menoufia Med J. 2018; 31(4):1253-7. Doi: http://www.mmj.eg.net/text.asp?2018/31/4/1253/252047

Alligood-Percoco NR, Kjerulff KH, Repke JT. Risk Factors for Dyspareunia After First Childbirth. Obstet Gynecol. 2016; 128(3):512-8. Doi: http://dx.doi.org/10.1097/AOG.0000000000001590

Andrews V, Thakar R, Sultan AH, Jones PW. Evaluation of postpartum perineal pain and dyspareunia--a prospective study. Eur J Obstet Gynecol Reprod Biol. 2008; 137(2):152-6. Doi: http://dx.doi.org/10.1016/j.ejogrb.2007.06.005

Espitia-De La Hoz FJ. Prevalence and characterisation of sexual dysfunctions in women, in 12 Colombian cities, 2009-2016. Rev Colomb Obstet Ginecol 2018; 69(1):9-21. Doi: http://dx.doi.org/10.18597/rcog.3035

Espitia-De La Hoz FJ. Prevalence of genitourinary syndrome of menopause and impact on sexuality of women in Quindío (Colombia), 2013-2016. Rev Colomb Obstet Ginecol. 2018; 69(4):249-59. Doi: http://dx.doi.org/10.18597/rcog.3111

Golding JM, Wilsnack SC, Learman LA. Prevalence of sexual assault history among women with common gynecologic symptoms. Am J Obstet Gynecol. 1998; 179(4):1013-9. Doi: http://dx.doi.org/10.1016/S0002-9378(98)70208-X

Chapman JD. A longitudinal study of sexuality and gynecologic health in abused women. J Am Osteopath Assoc 1989; 89(5):619-24. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2745177/

Solana-Arellano E, Villegas-Arrizón A, Legorreta-Soberanis J, Cárdenas-Turanzas M, Enzaldo de la Cruz J, Andersson N. Dispareunia en mujeres después del parto: estudio de casos y controles en un hospital de Acapulco, México. Rev Panam Salud Publica. 2008; 23(1):44–51. Disponible en: https://www.scielosp.org/pdf/rpsp/v23n1/a06v23n1.pdf

Chayachinda C, Titapant V, Ungkanungdecha A. Dyspareunia and sexual dysfunction after vaginal delivery in Thai primiparous women with episiotomy. J Sex Med 2015; 12:1275–82. Doi: http://dx.doi.org/10.1111/jsm.12860

Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA. 2005; 293(17):2141-8. Doi: http://dx.doi.org/10.1001/jama.293.17.2141

Barua H, Alamgir S, Dewan G. Routine Episiotomy Practice: A Study from Bangladesh. Journal of Rangamati Medical College. 2018; 1(2):3-4. Disponible en: https://www.researchgate.net/publication/332948285_Routine_Episiotomy_Practice_A_Study_from_Bangladesh

Oraif A. Routine Episiotomy Practice at a Tertiary Care Center in Saudi Arabia. Open Journa of Obstetrics and Gynecology. 2016; 6:794-7. Doi: http://dx.doi.org/10.4236/ojog.2016.613097

Wu LC, Lie D, Malhotra R, Allen JC Jr, Tay JS, Tan TC, Ostbye T. What factors influence midwives' decision to perform or avoid episiotomies? A focus group study. Midwifery. 2013; 29(8):943-9. Doi: http://dx.doi.org/10.1016/j.midw.2012.11.017

Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and Factors Associated With Episiotomy in Shahroud City, Northeast of Iran. International Journal of Women’s Health and Reproduction Sciences. 2016; 4(3):125–9. Doi: http://dx.doi.org/10.15296/ijwhr.2016.29

Tefera T, Kebede B, Mekonen T. Prevalence of episiotomy and factors associated with Practice of episiotomy at Saint Paul’s Hospital Millennium Medical College: a cross sectional study. Ethiopian Journal of Reproductive Health. 2019; 11 (3):33-40. Disponible en: http://ejrh.org/index.php/ejrh/article/view/306

Kartal B, Kızılırmak A, Calpbinici P, Demir G. Retrospective analysis of episiotomy prevalence. J Turk Ger Gynecol Assoc. 2017; 18(4):190-4. Doi: http://dx.doi.org/10.4274/jtgga.2016.0238

Kettle C, Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002; 359(9325):2217-23. Doi: http://dx.doi.org/10.1016/S0140-6736(02)09312-1

Morano S, Mistrangelo E, Pastorino D, Lijoi D, Costantini S, Ragni N. A randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth. J Minim Invasive Gynecol. 2006; 13(5):457-62. Doi: http://dx.doi.org/10.1016/j.jmig.2006.06.006

Elnagar WM. Median versus mediolateral episiotomy. Al-Azhar Assiut Medical Journal. 2015; 13(4):217-24. Disponible en: http://www.aamj.eg.net/journals/pdf/2712.pdf

Edessy M, Nasr AAM, El-Aty MGA, Ahmed W. Post Episiotomy Physical and Psychological Morbidities in Al Azhar University Hospital of Assiut -Upper Egypt. SOJ Gynecology, Obstetrics and Women’s Health. 2015; 1(1):1-4. Doi: http://dx.doi.org/10.15226/2381-2915/1/1/00102

Sultan AH, Thakar R, Ismail KM, Kalis V, Laine K, Räisänen SH, de Leeuw JW. The role of mediolateral episiotomy during operative vaginal delivery. Eur J Obstet Gynecol Reprod Biol. 2019; 240:192-6. Doi: http://dx.doi.org/10.1016/j.ejogrb.2019.07.005

Marty N, Verspyck E. Déchirures périnéales obstétricales et épisiotomie: aspects techniques. RPC prévention et protection périnéale en obstétrique CNGOF [Perineal tears and episiotomy: Surgical procedure - CNGOF perineal prevention and protection in obstetrics guidelines]. Gynecol Obstet Fertil Senol. 2018; 46(12):948-67. Doi: http://dx.doi.org/10.1016/j.gofs.2018.10.024

Sagi-Dain L, Sagi S. Indications for episiotomy performance - a cross-sectional survey and review of the literature. J Obstet Gynaecol. 2016; 36(3):361-5. Doi: http://dx.doi.org/10.3109/01443615.2015.1065233

Corrêa Junior M, Passini Júnior R. Selective episiotomy: Indications, techinique, and association with severe perineal lacerations. Rev Bras Ginecol Obstet. 2016; 38:301-7. Doi: http://dx.doi.org/10.1055/s-0036-1584942