• Postpartum rehabilitation and quality of life recovery in women with violations of perineum integrity during the delivery

Postpartum rehabilitation and quality of life recovery in women with violations of perineum integrity during the delivery

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2017.3(71):9-13; doi 10.15574/PP.2017.71.9

Davydova I. V.,  Ohorodnyk А. А., Baranova V. V., Limanskaya  А. Y., Skrupka А. А., Korniienko C. M., Butenko L. P.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Objective — to treat the diagnosed disorders and renew sexual relationship in the postpartum period with the help of the drug Gynodek (manufactured by Yuria-Pharm), a vaginal gel on the basis of decamethoxin, 0.5% hyaluronic acid, lactate buffer (pH 3.8–4.5), 5 ml, in plastic containers.
Material and methods. The research included 150 women with the violation of perineum integrity during the term delivery, including 75 women with mediolateral episiotomy (the 1st group) and 75 women with perineal rupture of grade I, who applied to the hospital in connection with complaints of sexual relationship violations in 2–4 months after childbirth. All women were completed the FSFI questionnaire, counselled by a perinatal psychologist, examined by obstetrician-gynaecologist, and they were administrated Gynodek in form of gel, 5 ml, once daily for 7 days. After 14–18 days from the completing of the abovementioned complex measures, the treatment efficacy evaluation of the sexual dysfunction was made. Statistical processing was made using Student's coefficient and Mann—Whitney U-test.
Results. After the treatment the significant improvement of sexual function was observed. Thus, the pain abatement according to FSFI was observed in 9.84±0.89 cases in the first group and 13.51±0.96 women in the second group, which, in comparison with the initial indexes, corresponded to a ratio of 1:3 (p>0,001). Due to the features of Gynodek (determined by hyaluronic acid and lactate buffer) there was observed a significant reduction of the contact bleeding and vaginal dryness (p>0.05). The normalization of vaginal microbiocenosis due to the effect of decamethoxin, was noted in 78.6% of women.
Conclusions. It is notable that the treatment efficacy of Gynodek was almost 2 times higher in the group of women with perineal rupture of grade I, which can be explained by the larger area of traumatisation during episiotomy.
Key words: rehabilitation, the drug Gynodek.


1. Carroli G, Mignini L. (2009). Episiotomy for vaginal birth. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD000081.pub2; PMid:19160176 PMCid:PMC4175536

2. DeLancey JOL. (2005). The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol. 192(5): 1488—1495. https://doi.org/10.1016/j.ajog.2005.02.028; PMid:15902147

3. Carpenter JS, Jones SM, Studts CR et al. (2016, Nov). Female Sexual Function Index Short Version: A MsFLASH Item Response Analysis. Arch Sex Behav. 45(8): 1897—1905. Epub 2016 Aug 8. https://doi.org/10.1007/s10508-016-0804-5; PMid:27502350 PMCid:PMC5053877

4. Bertozzi S, Londero AP, Fruscalzo A et al. (2010). Prevalence and Risk Factors for Dyspareunia and Unsatisfying Sexual Relationships in a Cohort of Primiparous and Secondiparous Women After 12 Months Postpartum. International Journal of Sexual Health. 22(1): 47—53. https://doi.org/10.1080/19317610903408130

5. Takahashi M, Inokuchi T, Watanabe C et al. (2011, Aug). The Female Sexual Function Index (FSFI): development of a Japanese version. J Sex Med. 8(8): 2246—2254. doi 10.1111/j.1743-09.2011.02267.x. Epub 2011 Apr 14.