{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:29:23Z","timestamp":1730870963401,"version":"3.28.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Schwangerschaft und Geburt eines Kindes stellen eine pr\u00e4gende\n                        Erfahrung mit Auswirkungen auf das K\u00f6rpergef\u00fchl und die\n                        Sexualit\u00e4t einer Mutter dar. Dabei wird in der Literatur bereits ein\n                        Einfluss des Geburtsmodus auf die postpartale Sexualit\u00e4t diskutiert.\n                        Ziel dieser Studie ist es nun, die Wiederaufnahme von vaginalem\n                        Geschlechtsverkehr (vag. GV.) und das Auftreten einer Dyspareunie in\n                        Abh\u00e4ngigkeit von prim\u00e4rer vs. sekund\u00e4rer Sectio zu\n                        untersuchen. Ebenso werden ein m\u00f6glicher Einfluss des Stillens, der\n                        (Still-)Amenorrhoe und hormoneller Kontrazeptiva auf die Wiederaufnahme des\n                        vag. GV n\u00e4her evaluiert. <\/jats:p><jats:p>\n          Methodik Von Oktober 2019 bis Juni 2020 wurden 525 Frauen nach\n                        erfolgter Sectio f\u00fcr eine prospektive, multizentrische Studie zur\n                        Erhebung von H\u00e4ufigkeit und assoziierten Beschwerden bei einer\n                        Isthmozele drei (3\u2009M. pp.) und sechs Monate postpartal (6\u2009M.\n                        pp.) rekrutiert. Im Rahmen dieser Studie wurden die Studienteilnehmerinnen\n                        zudem mittels Frageb\u00f6gen zur Wiederaufnahme des vag. GV, zum Stillen\n                        und zu potentieller Symptome wie \u201eDyspareunie\u201c und\n                        \u201eUnterbauchschmerzen\u201c befragt. Eingeschlossen wurden Frauen\n                        im Alter zwischen 18 und 40 Jahren, mit Einlings- oder\n                        Geminigravidit\u00e4t, ohne Plazentationsst\u00f6rung. <\/jats:p><jats:p>\n          Ergebnisse 66,4% der befragten Frauen gaben\n                        3\u2009M. pp. an wieder vag. GV aufgenommen zu haben, zu 6\u2009M. pp.\n                        79,7% (p&lt;0,001). Unter Einbeziehung des Sectio-Modus\n                        (prim\u00e4r vs. sekund\u00e4r) ergab sich weder ein signifikanter\n                        Unterschied bez\u00fcglich der Wiederaufnahme von vag. GV (Aufnahme vag.\n                        GV: 3\u2009M. pp. p=0,843, 6\u2009M. pp. p=0,236) noch\n                        bez\u00fcglich einer Dyspareunie (3\u2009M. pp. p=0,645,\n                        6\u2009M. pp. p=0,187). 6\u2009M. pp. litten 41,5% der\n                        Frauen nach prim\u00e4rer Sectio unter einer Dyspareunie und\n                        50,0% nach sekund\u00e4rer Sectio. Interessanterweise zeigten\n                        sich \u201eStillen\u201c und \u201eAusbleiben der\n                        Regelblutung\u201c als signifikante Einflussfaktoren auf das Auftreten\n                        einer Dyspareunie 3 und 6 Monate postpartal (Stillen: 3\u2009M. pp.\n                        p&lt;0,001; 6\u2009M. pp. p=0,010; Regelblutung:\n                        3\u2009M. pp. p&lt;0,001; 6\u2009M. pp. p=0,006). So\n                        zeigte sich bei Frauen, die stillten, h\u00e4ufiger eine Dyspareunie.\n                        Ebenfalls h\u00e4ufiger trat eine Dyspareunie bei Frauen auf, die\n                        \u201eAusbleiben der Regelblutung\u201c angaben. Die logistische\n                        Regression ergab 3\u2009M. pp. f\u00fcr Frauen, die nicht mehr\n                        stillten, ein geringeres Risiko f\u00fcr eine Dyspareunie\n                        (OR=0,46; 95%-Konfidenzintervall: 0,26\u20130,83;\n                        p=0,010), sowie ein h\u00f6heres Risiko f\u00fcr das Auftreten\n                        einer Dyspareunie bei Ausbleiben der Regelblutung (OR=1,98;\n                        95%-Konfidenzintervall: 1,15\u20133,43, p=0,014). 6\n                        Monate postpartal ergaben sich diese Zusammenh\u00e4nge in der\n                        logistischen Regression nicht mehr.<\/jats:p><jats:p>\n          Schlussfolgerungen Auch wenn sekund\u00e4ren Sectiones\n                        oftmals verz\u00f6gerte Geburtsphasen vorangehen und der Eingriff unter\n                        erschwerten Bedingungen durchgef\u00fchrt werden muss, zeigt sich in\n                        dieser Studie kein Einfluss auf die postpartale Sexualit\u00e4t. Eine\n                        (Still-)Amenorrh\u00f6 wurde hingegen als Faktor identifiziert, der\n                        vermehrt zu einer Dyspareunie f\u00fchren kann.<\/jats:p>","DOI":"10.1055\/a-1929-1785","type":"journal-article","created":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T00:57:40Z","timestamp":1668214660000},"page":"141-146","source":"Crossref","is-referenced-by-count":0,"title":["Eine Analyse zur Wiederaufnahme von Geschlechtsverkehr und dem\n                    Auftreten von Dyspareunie post sectionem"],"prefix":"10.1055","volume":"227","author":[{"given":"Katrin Alexandra","family":"Hees","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie,\n                    Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Speer","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin,\n                    Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Gozzi","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie,\n                    Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Berg","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie und Geburtsmedizin, Vivantes\n                    Clinic in Friedrichshain, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Hellmeyer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie und Geburtsmedizin, Vivantes\n                    Clinic in Friedrichshain, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Schlembach","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Vivantes Klinikum Neuk\u00f6lln,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus-Dieter","family":"Wernecke","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Biometrie und Klinische Epidemiologie,\n                    Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"David","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie,\n                    Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ejogrb.2005.04.008","article-title":"Rate of dyspareunia after delivery in primiparae according to mode of\n                    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