Hege Hølmo Johannessen

Prevalence and predictors of anal incontinence during pregnancy and 1 year after delivery: a prospective cohort study

To evaluate the prevalence and predictors of anal incontinence (AI) in late pregnancy and 1 year after delivery.

Anal incontinence and Quality of Life in late pregnancy: a cross‐sectional study

To evaluate the association between different types of anal incontinence (AI) and Quality of Life (QoL) in late pregnancy.

Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial.

To evaluate the effect of pelvic floor muscle exercises (PFME) for postpartum anal incontinence (AI).

Anal incontinence among first time mothers - what happens in pregnancy and the first year after delivery?

Pregnancy‐ and delivery‐related factors affect postpartum anal incontinence. We aimed to explore changes in continence status among primiparas from late pregnancy through the first year postpartum.

Prevalence and predictors of anal incontinence 6 years after first delivery

The main aim of the present study, was to explore prevalence and predictors of anal incontinence (AI) experienced 6 years after first delivery.

Anal incontinence after vaginal delivery or cesarean section

Uncertainties remain as to whether a cesarean section is protective for the short‐term and long‐term development of anal incontinence. Our aim was to explore whether women who had delivered only vaginally were at greater risk of anal incontinence than nulliparous women and women who had undergone cesarean sections only.

Pelvic Floor Physiotherapy for the Prevention and Management of Childbirth Trauma

Pregnancy and childbirth are known risk factors for weakening and injury to the perineum and pelvic floor muscles. Stretch and rupture of peripheral nerves, connective tissue and pelvic floor muscles may cause pelvic floor dysfunctions such as urinary and anal incontinence. Controlled trials have found pelvic floor muscle training to be effective in both prevention and treatment of incontinence. Common factors for all trials reporting a positive effect of pelvic floor muscle exercises (PFMT) in pregnancy or postpartum are found to be thorough clinical assessment of the women’s ability to perform a voluntary pelvic floor muscle contraction, close individual or group follow-up, and high adherence to the exercise protocol. Symptoms of incontinence before or during pregnancy have been found to be the main risk factors for incontinence symptoms postpartum. Similarly, women with symptoms of incontinence in the first year after delivery have an increased risk of long term incontinence symptoms. The cost of incontinence-related illness is a substantial economic and human burden, highlighting the need for effective forms of prevention and management.

Authors' reply re: Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial

Sir, We thank Drs Ryu and colleagues for their interesting comments in response to our trial on gestational weight gain (GWG) in overweight and obese women. We agree that GWG and obesity in pregnancy are important, partly overlapping factors in adverse pregnancy outcomes, and that a significant amount of research has focused on methods to reduce GWG. We note that in meta-analysis, dietary interventions appear to be most successful at reducing GWG, compared with exercise or other interventions, but studies have shown mixed results in reducing the incidence of other important adverse maternal and neonatal outcomes. Our study and others’ results have led us to revise our initial hypothesis: we now feel that serial self-weighing alone is unlikely to alter GWG or health outcomes for overweight and obese women and their children in any predictable way. Nevertheless, it is extremely reassuring to know that women do not suffer anxiety or diminished quality of life when they participate in research aimed at controlling GWG. We anticipate that serial self-weighing will remain in research and clinical practice. For example, we await results from a low-cost, woman centred, mobile-health (mhealth) intervention for overweight and obese pregnant women in which serial self-weighing is one component.&