BOOST: Behavioral Therapy Of Obstetric Sphincter Tears
Study Details
Study Description
Brief Summary
The study design will be a cohort study to determine the incidence of FI symptoms at 6, 12 and 24 weeks postpartum in primiparous women sustaining an OASI. At 6, 12 and 24 weeks postpartum, subjects will be contacted by telephone for evaluation of FI symptoms. Symptoms of FI will be defined by at least monthly symptoms of leakage of liquid, solid stool, and mucus. Flatal incontinence will be assessed at 24 weeks, based on the Fecal Incontinence Severity Index, and fecal urgency will be assessed at 24 weeks based on the one question from the Modified Manchester questionnaire. A sample size of approximately 400-450 subjects will be enrolled.
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
The primary aim of the "BOOST Cohort Study" is to determine the incidence of FI symptoms at 6 and 12 weeks postpartum in primiparous women sustaining an OASI.
Secondary aims of the cohort study are:
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To determine the incidence rates of FI symptoms at 24 weeks post delivery in primiparous women sustaining an OASI
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To examine the relationship between the modified WHO sphincter tear classification types and FI symptoms
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To examine predictors (socio-demographic, physical and clinical) associated with WHO sphincter tear classifications (3a, 3b and 4) and predictors associated with FI symptoms
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To evaluate the incidence of fecal urgency and flatal incontinence at 24 weeks postpartum in primiparous women sustaining an OASI.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Primiparous women with an obstetric anal sphincter tear Subjects in this trial will be primiparous women who underwent anal sphincter repair at the time of a singleton vaginal delivery. Sphincter tears will be clinically characterized at the time of delivery as <50% tear through the anal sphincter (modified WHO 3a), >50% (modified WHO 3b), or complete tear through the anal sphincter (4th degree). Subjects in this study will not have receive study interventions. |
Outcome Measures
Primary Outcome Measures
- Incidence of FI [6 and 12 months postpartum]
The primary aim for this study is to determine the incidence of FI symptoms (based on the FISI)at 6 and 12 weeks postpartum in primiparous women sustaining an OASI.
Secondary Outcome Measures
- Incidence of FI [24 weeks postpartum]
A secondary aim for this study is to determine the incidence of FI symptoms (based on the FISI) at 24 weeks postpartum in primiparous women sustaining an OASI.
- Fecal urgency [24 weeks postpartum]
Fecal urgency will be assessed at 24 weeks based on the one question from the Modified Manchester questionnaire
Eligibility Criteria
Criteria
Inclusion Criteria Assessed by 2 weeks postpartum
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Vaginal delivery >= 28 weeks singleton gestation
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Documented repair to the anal sphincter at delivery
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First vaginal delivery
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Ambulatory
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Able to give informed consent 6 Adult women >= 18 years of age
Inclusion Criteria at 2 weeks postpartum
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Inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease)
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Pre-pregnancy ano-rectal surgery (e.g., surgery for hemorrhoids, fissures, sphincterotomy)
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Pre-pregnancy FI (defined as the leakage of liquid/solid stool and mucus >= once per month for at least 12 weeks prior to this pregnancy)
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Neurological condition that would predispose to FI (e.g., spinal cord injury, multiple sclerosis)
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Presence of rectovaginal fistula
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Any participation in other pharmacologic or behavioral studies for FI
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Previous pregnancy >=28 weeks delivered vaginally or by Cesarean section
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | University of Alabama at Birmingham | Birmingham | Alabama | United States | 35294 |
2 | University of California San Diego | La Jolla | California | United States | 92037 |
3 | Loyola University | Maywood | Illinois | United States | 60153 |
4 | Duke University | Durham | North Carolina | United States | 27710 |
5 | Cleveland Clinic | Cleveland | Ohio | United States | 44195 |
6 | University of Pittsburgh | Pittsburgh | Pennsylvania | United States | 15260 |
7 | University of Texas Southwestern | Dallas | Texas | United States | 75390 |
8 | University of Utah | Salt Lake City | Utah | United States | 84132 |
Sponsors and Collaborators
- NICHD Pelvic Floor Disorders Network
- Office of Research on Women's Health (ORWH)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Investigators
- Study Chair: Holly E Richter, PhD, MD, University of Alabama at Birmingham
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- 20P01