{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:23:10Z","timestamp":1790144590994,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Childbirth brings many changes to women\u2019s life and sexual health. The influence of operative vaginal delivery on sexual function has produced inconsistent results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the effects of mode of vaginal delivery (spontaneous or operative) in postpartum sexual function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptive prospective study (MOODS- Maternal-neonatal Outcomes in Operative Vaginal Delivery) including 304 women who had a singleton term vaginal delivery (operative or spontaneous in a relation 2:1). Women were invited to answer a questionnaire at 3, 6 months and 1 year postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes Measurement<\/jats:title><jats:p>A validated questionnaire was applied, the Female Sexual Function Index (FSFI) Score, to evaluate effects of operative delivery on sexual health. Sexual dysfunction was defined by FSFI score &amp;lt;26.55.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>211 women answered at least one questionnaire. Overall rate of sexual dysfunction was 62%, 43% and 48% at 3, 6 and 12 months respectively. At 3 months, total FSFI score was significantly lower in operative vaginal delivery group (mean\u00b1SD, 21.3\u00b18.6 vs 24.9\u00b17.9, P = 0.015). Arousal (P = 0.028), orgasm (P = 0.029), satisfaction (P = 0.015) and pain (P = 0.007) FSFI domains were also significantly inferior. At this time, 44% women in spontaneous delivery group and 70% in operative delivery group had sexual dysfunction (P = 0.0002). At 6 months, there were no differences in FSFI scores according the type of delivery. At 12 months, total FSFI score was similar in both groups, but pain domain was significantly lower in operative delivery (P = 0.004). Considering type of instrument (Thierry\u2019s Spatulas or Kiwi Vacuum), no differences were found regarding episiotomy, perineal trauma, obstetric anal sphincter injury or postpartum complications. FSFI scores did not differ between the two instruments at any time point. A logistic regression showed that, when controlled for perineal trauma, mode of delivery was independently associated with sexual dysfunction at 3 months (P = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>Clinicians should assess women\u2019s sexual health during pregnancy and postpartum period in order to enhance their wellbeing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths\/Limitations<\/jats:title><jats:p>Strengths include its prospective design, standardized questionnaire and the new perspectives about a different obstetrical instrument (Thierry\u2019s spatulas). Limitations include the absence of pre-pregnancy sexual function data and considerable drop-out rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Sexual dysfunction affects a great proportion of newly mothers and in postpartum period mode of delivery and perineal trauma seem to play an important role. Although there was a progressive reduction over time, prevalence of sexual dysfunction at 6 months and 1 year postpartum was still considerable. The type of obstetrical instrument does not seem to influence short or long-term sexual function.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jsxm.2021.04.002","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T06:23:51Z","timestamp":1622183031000},"page":"1075-1082","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study"],"prefix":"10.1093","volume":"18","author":[{"given":"Natacha Quintal","family":"de Sousa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Catarina","family":"Borges","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Sarabando","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Bivar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Viana","sequence":"additional","affiliation":[{"name":"School of Medicine, Life and Health Sciences Research Institute, University of Minho , Braga , Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory , Braga\/Guimar\u00e3es , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"School of Medicine, Life and Health Sciences Research Institute, University of Minho , Braga , Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory , Braga\/Guimar\u00e3es , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"},{"name":"School of Medicine, Life and Health Sciences Research Institute, University of Minho , Braga , Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory , Braga\/Guimar\u00e3es , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Nogueira-Silva","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital de Braga , Braga , Portugal"},{"name":"School of Medicine, Life and Health Sciences Research Institute, University of Minho , Braga , Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory , Braga\/Guimar\u00e3es , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"2023041407023051100_","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.esxm.2019.10.005","article-title":"Postpartum female sexual function: Risk factors for postpartum sexual dysfunction","volume":"8","author":"Gutzeit","year":"2020","journal-title":"J Sex Med"},{"key":"2023041407023051100_","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s13643-019-1079-4","article-title":"Sexual dysfunction and related factors in pregnancy and postpartum: A systematic review and meta-analysis protocol","volume":"8","author":"Banaei","year":"2019","journal-title":"BMC Syst Rev"},{"key":"2023041407023051100_","article-title":"Postpartum care of the mother and newborn: A practical guide. 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