Fernandi Moegni

Dr. Cipto Mangunkusumo Hospital, Indonesia

Title: A randomized control trial of platelet-rich plasma in supporting the recovery of postpartum levator ani muscle trauma

Abstract

Childbirth may cause pelvic floor muscle trauma (macrotrauma avulsion or microtrauma ballooning) which are two independent risk factors for development of Pelvic floor Dysfunction (PFD) like pelvic organ prolapse or stress urinary incontinence in the future. We use Platelet rich plasma (PRP) which is rich in growth factors that were released from platelet’s alpha granules, in order to enhance recovery of levator ani muscle (LAM). PRP is prepared by spinning a patient's blood using a centrifuge to separate plasma from cells, then injecting this plasma locally to the specific site of puborectal muscle.

From our prospective, single blind, randomized control study of 63 primigravid women, 22 were suffered microtrauma ballooning, 5 macrotrauma avulsion, divided into 2 groups that were injected either with autologous PRP or placebo at LAM during perineorrhaphy postpartum. Transperineal ultrasound and perineometry was used to assess the levator hiatal area (LHA) on valsalva and LAM contraction strength at the third trimester of pregnancy, 40 days postpartum and three months postpartum.

At 3 months post-partum the intervention group had significantly reduced the wide area of LHA on valsalva, in contrast with worsening condition in the control group. LAM contraction strength reduction was found statistically significant in the control group, not in the intervention group. In five avulsion cases at 40 days postpartum evaluation, evaluation at 3 months revealed 3 out of 4 intervention subjects were recovered compared with one control subject who remained suffering avulsion at 3 months postpartum evaluation.

Platelet rich plasma can be a promising alternative therapy for microtrauma ballooning or macrotrauma avulsion of pelvic muscle trauma in primiparous women to reduce the incidence of PFD complication in the future by reducing the levator hiatal area, increasing LAM contraction strength and also healing avulsion.

Biography

Fernandi Moegni is an obstetrics and gynecology doctor subspecializing in Urogynecology and reconstruction. Currently, he practices at the Moegni Main Clinic and YPK Mandiri Hospital. The medical services he can provide include: Consultations regarding Obstetrics and Gynecology health. He studied General Medicine at the University of Indonesia, graduating in 1999, then studied Obstetrics and Gynecology Specialist at the University of Indonesia, graduating in 2004. After that, he studied Urogynecology and reconstruction subspecialty at the University Indonesia. He also received training in the same field, Urogynecology, in Singapore. In 2009 he received training in Pelvic Floor Ultrasound at Nepean Hospital, Australia. Apart from being active as a teaching staff in the Department of Obstetrics and Gynecology, he is active in several organizations including the International Continence Society (ICS) and the International Uro-Gynecological Association (IUGA). Currently, he is active as head of the Obstetrics Gynecology specialist education program at the Faculty of Medicine, University of Indonesia.

2nd International Conference on Gynecology and Obstetrics

Fernandi Moegni

Title: A randomized control trial of platelet-rich plasma in supporting the recovery of postpartum levator ani muscle trauma

Abstract

Biography

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