443 Association between striae gravidarum and pelvic floor dysfunction symptoms during the third trimester of pregnancy

Abstract

The exact pathophysiology of striae gravidarum (SG) is unknown but it has been postulated that some pregnancy induced changes in the connective tissue (CT) might be a contributing factor. Pelvic floor distress (PFD) symptoms are also known to be linked to CT weakness. We sought to examine whether an association exists between presence of SG and presence of pelvic floor distress (PFD) symptoms during late pregnancy. A prospective cohort study was conducted using the Pelvic Floor Distress Inventory -20 (PFDI-20) questionnaire which is a validated questionnaire serving as a quality-of-life instrument developed to measure the extent of injury to the pelvic floor , that has been validated in non-pregnant and pregnant women. Our cohort included women who visited the Soroka University Medical Center for routine pregnancy follow up during the 3d trimester of pregnancy and were asked to complete the PFDI-20 questionnaire regarding third trimester PFD symptoms. The severity of SG was calculated using the Davey scoring system. Women with connective tissue disease, those in active labor, with multiple pregnancy, polyhydramnios (defined as amniotic fluid index greater than 25) or with a history of pelvic floor surgery where excluded from the study. Univariate analysis was carried using appropriate tests, PFDI ranking was compared between the groups using Mann Whitney test. Of 187 women who were found eligible and had completed the questionnaire , 81 (43.3%) did not have SG, 24 (12.8%) had mild SG, 43 (23%) had moderated SG and the remaining 39 (20.9%) had severe SG. The distribution of median PDFI-20 scores according to presence and severity of SG are presented in table 1. The overall and median PFDI-20 scores differed between the groups, yet a distinct trend of an association between the PFDI-20 score and severity of SG was not demonstrated. In our population, we were able to demonstrate an association between PFD symptoms as evident by the PFDI-20 scores and presence of SG. Our findings highlight the theory of a common CT involvement in the pathophysiology of both conditions.