Lower limb afferent nerve function in relation to childbirth
Research type
Research Study
Full title
Clinical study of lower limb afferent nerve function in relation to childbirth
IRAS ID
195870
Contact name
Momotaz Sultana
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
2 years, 0 months, days
Research summary
Faecal incontinence (FI) is the involuntary passage of stool. It is a distressing condition that is common, but under-reported because of embarrassment. Women who have had children are more likely to have FI than women who have not (nulliparous). FI can occur immediately after delivery, years later, or not at all. We cannot accurately predict who will develop FI.
Injury to the muscles of the back passage (anal sphincters) that maintain continence, sometimes occurs in vaginal deliveries. The extent of sphincter damage does not equate well with eventual development of incontinence, indicating that other factors influence continence. We know that pelvic nerves that control the anal muscles can also be damaged during childbirth, contributing to the development of FI. Assessing these nerves requires the indignity and discomfort of an internal examination. The test itself is expensive and inaccurate.
Recent research in parous women with FI suggests that we might be able to assess the nerves in the leg as a marker for injured pelvic nerves. At QMUL, we will conduct two studies to test this hypothesis. Study 1 will compare parous women with and without FI, nulliparous women and patients with known lower limb nerve injury. In study 2, women in their first pregnancy will be assessed before and after childbirth. Study 1&2 require a clinical interview, questionnaires, examination and nerve tests, used in neurological practice. They carry no risk to participants.
By improving our understanding of the mechanism and sequence of nerve injury in pregnancy and labour, doctors will be better placed at identifying women who are at greater risk of developing FI. This will form the basis of early intervention to prevent or minimise this distressing problem; reducing the financial and social burden of FI. This could be achieved using safe, non-invasive, inexpensive tests on the leg.
Injury to the muscles of the back passage (anal sphincters) that maintain continence, sometimes occurs in vaginal deliveries. The extent of sphincter damage does not equate well with eventual development of incontinence, indicating that other factors influence continence. We know that pelvic nerves that control the anal muscles can also be damaged during childbirth, contributing to the development of FI. Assessing these nerves requires the indignity and discomfort of an internal examination. The test itself is expensive and inaccurate.
Recent research in parous women with FI suggests that we might be able to assess the nerves in the leg as a marker for injured pelvic nerves. At QMUL, we will conduct two studies to test this hypothesis. Study 1 will compare parous women with and without FI, nulliparous women and patients with known lower limb nerve injury. In study 2, women in their first pregnancy will be assessed before and after childbirth. Study 1&2 require a clinical interview, questionnaires, examination and nerve tests, used in neurological practice. They carry no risk to participants.
By improving our understanding of the mechanism and sequence of nerve injury in pregnancy and labour, doctors will be better placed at identifying women who are at greater risk of developing FI. This will form the basis of early intervention to prevent or minimise this distressing problem; reducing the financial and social burden of FI. This could be achieved using safe, non-invasive, inexpensive tests on the leg.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
16/LO/0719
Date of REC Opinion
25 May 2016
REC opinion
Further Information Favourable Opinion