Outcomes of Delivery in Patients With Dyspareunia

Study Overview
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Brief Summary
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The focus of this pilot study is to determine if a woman who experiences pain during sexual intercourse has a higher risk of complications during labor and delivery secondary to pelvic floor dysfunction, anxiety and intolerance towards pelvic examinations. Furthermore, it is unclear whether women with prepartum dyspareunia experience an improvement following vaginal delivery. While physicians may expect that vaginal birth improves dyspareunia due to the stretching effect on pelvic floor, to date, there is insufficient evidence to support this claim. The Investigators plan to prospectively study 200 patients at our Institution, collect information regarding birth and follow them, via questionnaires, regarding their dyspareunia postpartum.

Official Title
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Outcomes of Delivery in Patients With Dyspareunia- A Prospective Study

Conditions
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Pregnancy, Dyspareunia, Provoked Vestibulodynia, Pelvic Floor Dysfunction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 200 nulliparous women admitted to the Labor and Delivery Department at the Hadassah Medical Center, above the age of 18. Able and willing to read, understand, and sign the Informed Consent Form and questionnaire. Agree to be contacted in the future to complete telephone questionnaires. Exclusion Criteria: Induction of labor Placental abruption, placenta previa Malpresentation Non reassuring fetal heart rate upon admission Any other contraindication for vaginal delivery Multifetal pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Definite diagnosis of dyspareunia<br>Patients who report dyspareunia, and whose dyspareunia was evaluated prior to delivery by a caregiver experienced with sexual pain disorders, with definite diagnosis. | |
| No definite diagnosis of dyspareunia<br>Patients who report dyspareunia but were not evaluated prior to delivery or were evaluated inappropriately (i.e. yeast infection without cultures, inflammation and other vague definitions). | |
| Patients without dyspareunia<br>Patients without dyspareunia- those who report non painful sexual intercourse. This group of patients will be used as a control group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Obstetrical outcome of women with a history of dyspareunia | The Investigators will record the mode of delivery (vaginal, instrumental or cesarean section), length of the second stage of labor, use of anesthetics, perineal tears and\or episiotomies, and newborn's birth weight. The evaluation will be done prospectively, comparing data with matched controls without a history of dyspareunia. | 3 months -1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of alleviation of dyspareunia following vaginal delivery as assessed through patient questionnaires. |  | 2 years |