Postpartum Health Trajectories the First Year After Obstetric Anal Sphincter Injury and the Impact of a Group-Based Intervention

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18+
SponsorHanna Jangö

About this trial

The aim of the ADAPT study is to investigate whether a structured, group-based follow-up programme can improve quality of life related to anal incontinence in women with OASI during the first year after childbirth. The study will also describe how symptoms change over time and assess effects on mental health, sexual function, symptoms of prolapse and urinary incontinence, and body image.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Obstetric Anal Sphincter Injury (OASI - Grade 3-4 tear) and clinical follow-up postpartum at the "Pelvic Clinic" at Herlev Hospital

18 years of age or above and the capacity to provide informed consent

Fluent in Danish language

Disqualifiers

Referred patients from other hospitals due to complicated healing

Patients where other Hospitals are responsible for the clinical follow-up

Trial design

Design model

Parallel

Treatments tested in this trial

  • Group Session

    Other intervention

    Participants in the Intervention Group are invited to three closed group sessions 2-6 months postpartum hosted by doctors and physiotherapists. The group session focus on relevant information (e.g. healing, incontinence, emotions, concerns, sexlife, everyday challenges), kegel-exercises (pelvic floor exercises) and social interaction between participants.

Treatment groups

110 Participants
are divided into 2 treatment groups
Group A: ControlNo intervention 0 interventions
Group B: InterventionActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

ICIQ-B Quality of Life Domain

The change in score of the "Quality of Life" Domain in ICIQ-Bowel (Questions 19-23) between the Intervention and the Control Group

Time frame
From Baseline questionnaire (1-1.5 months postpartum) to last questionnaire at 9-12 months postpartum
2

Symptoms of Anal Incontinence (Cohort)

Development/fluctuation of anal incontinence and related symptoms for all participants regardless of randomization (cohort) at all timepoints.

Time frame
From 8-14 days and at 1-1.5, 3, 6 and 9-12 months

Secondary outcomes

1

ICIQ-B (total) score

The change in total ICIQ-Bowel score (all domains). Between the Intervention and the Control group at all timepoints, and for all participants (the cohort) the development over time.

Time frame
From Baseline questionnaire (1-1.5 months postpartum) and at 3, 6 and 9-12 months postpartum
2

Anal Incontinence symptoms

Anal Incontinence symptoms derived from early + late clinical follow-up and relevant ICIQ-B items. Between the Intervention and the Control group at all timepoints.

Time frame
From 8-14 days postpartum and at 1-1.5, 3, 6 and 9-12 months
3

EAUS

Assessment of defects in anal sphincter complex by endoanal ultrasound . Between the Intervention and the Control group, and for all participants (the cohort).

Time frame
At 9-12 months clinical follow-up
4

Wound dehiscence

Wound dehiscence at early clinical follow-up (8-14 days). Wound dehiscence is divided into with/without involvement of pelvic muscles (With/without involvement of sphincter-complex or total dehiscence). Between the Intervention and the Control group, and for all participants (the cohort)

Time frame
At early clinical follow-up (8-14 days postpartum)

Other outcomes

1

Levator Ani Avulsion

Assessment of levator Ani Avulsion from Endovaginal Ultrasound. Presence, severity and association with symptoms and Quality of Life. Between the Intervention and the Control group at all timepoints, and for all participants (the cohort).

Time frame
At 9-12 months clinical follow-up
2

Qualitative Component (Intervention group only)

Semi-structured individual or focus-group interviews will explore participants' experiences with the intervention and explore women's experiences of sustaining a perineal tear and any associated symptoms

Time frame
Aprox. 2-8 weeks after concluded intervention

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Hanna Jangö

Lead sponsor

Herlev Hospital

Sponsor institution

This trial is not recruiting at the moment. You can still explore other options: