FERNANDA PIPITONE RODRIGUES
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Novel 3D MRI technique to measure perineal membrane structural changes with pregnancy and childbirth: Technique development and measurement feasibility(2021) PIPITONE, Fernanda; SWENSON, Carolyn W.; DELANCEY, John O. L.; CHEN, LuyunIntroduction and hypothesis We aimed to develop and validate a new MRI-based perineal membrane reconstruction and morphological measurement technique, and test its feasibility on nulliparous and parous women to determine the effects of pregnancy and childbirth on the perineal membrane. Methods The perineal membrane was traced on high-resolution MRI using 3D Slicer (R) and analyses performed using Rhinoceros 6.0 SR23 (R). Validation was done by comparing MRI-based perineal membrane reconstruction to dissection measurements in a cadaver. Feasibility of reconstruction was assessed in the following three groups: nulliparous (NP), primiparous women who underwent cesarean delivery (CD), and primiparous women with vaginal delivery (VD). The following parameters were measured: (1) swinging door angle, (2) bony and (3) soft tissue attachment lengths, (4) separation at perineal body level, (5) surface area, and (6) hiatal area. ANOVA and post-hoc comparisons were performed, and the effect sizes (d) were reported. Results Model reconstruction was similar to cadaver dissection findings. Morphological measurements were feasible in all women (NP, n = 10; CS, n = 6; VD, n = 19). Swinging door angle was 13(o) greater in CD (p = 0.03; d = 1.15) and 16(o) greater in VD (p < 0.001; d = 1.41) compared to NP. VD showed 13% larger separation at the perineal body than NP (p = 0.097, d = 0.84) and 23% larger hiatal area than CD (p = 0.14, d = 0.94). Conclusion This novel and anatomically validated MRI-based perineal membrane reconstruction technique is feasible. Preliminary findings show that pregnancy and childbirth both influence perineal membrane morphology with VD being associated with the largest swinging door angle and perineal body separation.
conferenceObject INTRAVESICAL TREATMENTS WITH HYALURONIC ACID AND CHONDROITIN FOR PAINFUL BLADDER SYNDROME: SYSTEMATIC REVIEW AND META-ANALYSIS(2015) MATSUOKA, P. K.; RODRIGUES, F. P.; PACETTA, A. M.; BARACAT, E. C.; HADDAD, J. M.conferenceObject Functional anatomy of the perineal complex as it relates to urogenital hiatus closure(2023) DELANCEY, J. O.; XIE, B.; PIPITONE, F.; SWENSON, C. W.; MASTELING, M.; CHEN, L.conferenceObject Perineal membrane and prolapse in young women: Assessment of morphological changes using MRI-based 3D surface model(2022) PIPITONE, F.; SWENSON, C.; DELANCEY, J.; CHEN, L.- The postpartum silence(2022) PIPITONE, Fernanda; DELANCEY, John O.
conferenceObject Pelvic floor structures fiber direction after vaginal birth as seen on ultrasound: feasibility study(2023) PIPITONE, F.; MASTELING, M.; CHEN, L.; HADDAD, J. Milhem; DELANCEY, J. O.conferenceObject Perineal membrane: 3D transvaginal ultrasound optimal visualization plane assessment verified on MRI(2022) PIPITONE, F.; MASTELING, M.; CHEN, L.; SWENSON, C.; FAIRCHILD, P.; HADDAD, Milhem J.; DELANCEY, J.conferenceObject Appearance of the Normal and Abnormal Perineal Membrane On MRI(2022) PIPITONE, F.; CHEN, L.; SWENSON, C.; HADDAD, Milhem J.; DELANCEY, J.- Hiatal failure: effects of pregnancy, delivery, and pelvic floor disorders on level III factors(2023) CHENG, Wenjin; ENGLISH, Emily; HORNER, Whitney; SWENSON, Carolyn W.; CHEN, Luyun; PIPITONE, Fernanda; ASHTON-MILLER, James A.; DELANCEY, John O. L.Introduction and hypothesis The failure of the levator hiatus (LH) and urogenital hiatus (UGH) to remain closed is not only associated with pelvic floor disorders, but also contributes to recurrence after surgical repair. Pregnancy and vaginal birth are key events affecting this closure. An understanding of normal and failed hiatal closure is necessary to understand, manage, and prevent pelvic floor disorders. Methods This narrative review was conducted by applying the keywords ""levator hiatus"" OR ""genital hiatus"" OR ""urogenital hiatus"" in PubMed. Articles that reported hiatal size related to pelvic floor disorders and pregnancy were chosen. Weighted averages for hiatal size were calculated for each clinical situation. Results Women with prolapse have a 22% and 30% larger LH area measured by ultrasound at rest and during Valsalva than parous women with normal support. Women with persistently enlarged UGH have 2-3 times higher postoperative failure rates after surgery for prolapse. During pregnancy, the LH area at Valsalva increases by 29% from the first to the third trimester in preparation for childbirth. The enlarged postpartum hiatus recovers over time, but does not return to nulliparous size after vaginal birth. Levator muscle injury during vaginal birth, especially forceps-assisted, is associated with increases in hiatal size; however, it only explains a portion of hiatus variation-the rest can be explained by pelvic muscle function and possibly injury to other level III structures. Conclusions Failed hiatal closure is strongly related to pelvic floor disorders. Vaginal birth and levator injury are primary factors affecting this important mechanism.