(Adapated from Applicant's Description): This proposal is submitted in response to RFA HD-99-003 """"""""Basic Science Research on Female Pelvic Floor Disorders."""""""" Described in this application is a comprehensive multidisciplinary basic and clinical science research program focused specifically on the relationship of childbirth to pelvic floor injury. Three research components are presented to include (1) a prospective analysis of the relationship between precise obstetrical events and subsequent pelvic floor dysfunction in 11,000 primiparous women; (2) a randomized trial of the effects of coached maternal pushing during the second stage of labor on postpartum pelvic floor function; and (3) utilization of a novel animal model to study the effects of vaginal trauma during pregnancy on lower urinary tract smooth muscle contractility and contractile protein gene expression. Sample sizes for the aims described in this application are based upon ad hoc power analyses. This proposal also describes the qualifications and experience of basic and clinical investigators at the University of Texas Southwestern Medical Center and Parkland Hospital who are committed to the study of childbirth related pelvic floor injury. Included are individuals with expertise in maternal-fetal medicine, urogynecology, and smooth muscle physiology. Existing resources include operational laboratories to support the basic science research described, a well functioning computerized perinatal database to support analysis of precise obstetrical events related to pelvic floor injury and an established, well-functioning infrastructure capable of completing randomized clinical trials. Integral to this infrastructure is a well-functioning state-of-the-art urogynecologic clinical laboratory. The major focus of this application is on its theme of multidisciplinary basic and clinical research focused specifically on childbirth which is the singular most important, predisposing factor to pelvic floor injury.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD038663-03
Application #
6536092
Study Section
Special Emphasis Panel (ZHD1-RRG-K (03))
Program Officer
Parrott, Estella C
Project Start
2000-04-01
Project End
2005-03-31
Budget Start
2002-04-01
Budget End
2003-03-31
Support Year
3
Fiscal Year
2002
Total Cost
$185,423
Indirect Cost
Name
University of Texas Sw Medical Center Dallas
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
City
Dallas
State
TX
Country
United States
Zip Code
75390
Wai, Clifford Y; McIntire, Donald D; Atnip, Shanna D et al. (2011) Urodynamic indices and pelvic organ prolapse quantification 3 months after vaginal delivery in primiparous women. Int Urogynecol J 22:1293-8
Bloom, Steven L; Casey, Brian M; Schaffer, Joseph I et al. (2006) A randomized trial of coached versus uncoached maternal pushing during the second stage of labor. Am J Obstet Gynecol 194:10-3
Casey, Brian M; Schaffer, Joseph I; Bloom, Steven L et al. (2005) Obstetric antecedents for postpartum pelvic floor dysfunction. Am J Obstet Gynecol 192:1655-62
Schaffer, J I; Bloom, S L; Casey, B M et al. (2005) A randomized trial of the effects of coached vs uncoached maternal pushing during the second stage of labor on postpartum pelvic floor structure and function. Am J Obstet Gynecol 192:1692-6
Wai, Clifford Y; Liehr, Peter; Boreham, Muriel K et al. (2004) Effect of periurethral denervation on smooth muscles of the lower urinary tract. Am J Obstet Gynecol 191:1950-60
Wai, C Y; Liehr, P; Tibbals, H F et al. (2003) Effect of periurethral denervation on function of the female urethra. Am J Obstet Gynecol 189:1637-45
Boreham, Muriel K; Wai, Clifford Y; Miller, Rodney T et al. (2002) Morphometric properties of the posterior vaginal wall in women with pelvic organ prolapse. Am J Obstet Gynecol 187:1501-8; discussion 1508-9
Boreham, M K; Miller, R T; Schaffer, J I et al. (2001) Smooth muscle myosin heavy chain and caldesmon expression in the anterior vaginal wall of women with and without pelvic organ prolapse. Am J Obstet Gynecol 185:944-52