Antenatal and Postnatal Screening for Pelvic Floor Dysfunction Using an Electronic Patient Reported Outcome Measure

Area of Science:

• Obstetrics and Gynecology
• Pelvic Health
• Digital Health

Background:

• Pregnancy and childbirth are leading causes of pelvic floor dysfunction (PFD).
• Routine screening for antenatal and postnatal PFD is not standard practice in the UK.
• Early identification and intervention are crucial for managing PFD.

Purpose of the Study:

• To identify antenatal and postnatal women experiencing PFD.
• To utilize a validated electronic patient-reported outcome measure (ePROM) for screening.
• To provide targeted interventions based on symptom severity scores.

Main Methods:

• 15,093 patients were invited to complete the ePAQ-Pelvic Floor ePROM across three NHS hospitals.
• Respondents were categorized into antenatal and postnatal cohorts.
• Symptom scores determined triage to therapy assistant practitioners or specialist physiotherapists/urogynaecologists.

Main Results:

• 3366 ePROMs were completed (22.3% response rate); 1804 antenatal and 806 postnatal participants consented.
• Postnatal women reported significantly worse mean domain scores for stress urinary incontinence, bowel continence, pelvic organ prolapse, dyspareunia, body image, and sexual function (p < 0.0001).
• 601 patients were referred to physiotherapy assistants and 150 to specialists.

Conclusions:

• Electronic PROMs are effective tools for identifying antenatal and postnatal women at risk of PFD.
• Postnatal women exhibit a higher burden of PFD symptoms.
• Further research is needed on optimal ePROM instruments, patient acceptability, and response rate improvement.