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Objective:To assess the efficacy and security of 2 940 nm Er∶YAG laser combined with electronic injection of collagen in treatment of striae gravidarum.Methods:The symmetrical spots on both sides of abdomen of 21 subjects with striae gravidarum were divided into treatment and control groups by simple randomization method in the Department of Burn and Plastic Surgery, 903 Hospital from November 2017 to May 2019. The treatment group were treated with 2 940 nm Er∶YAG laser combined with electronic injection of collagen every 2 months for 3 sessions, and control group were received 2 940 nm Er∶YAG laser combined with electronic injection of physiological saline. The total effective rate, satisfaction, striae width, histopathology, and the adverse reaction were evaluated at 6 months after treatment.Results:A total of 19 subjects completed the whole trail. The clinical effective rate of the treatment group was 89.47% and the control group was 68.42%. In the treatment group, 11 cases were satisfied with and 6 cases were very satisfied with treatment outcome. In the treatment group, 8 cases were satisfied with and 3 cases were very satisfied with treatment outcome. The difference of total effective rate and satisfaction was statistically significant ( χ2 was 3.91 and 5.54, P was 0.045 and 0.019). The maximum width decreased by (1.53±0.97) mm on treatment side, and (1.37±1.01) mm on control side. The difference of striae width was statistically significant. No adverse effect was observed on both sides. Conclusions:The combination of the 2 940 nm Er∶YAG laser with electronic injection of collagen for treatment of striae gravidarum is a safe and effective approach for improving of striae gravidarum.
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Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from 1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.
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Abdominal stretch marks found during pregnancy may be indicative of poor skin elasticity. One who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during vaginal delivery. Striae gravidarum (SG) is a common phenomenon of stretch marks observed during pregnancy that may be an indicator of poor skin elasticity. The type and amount of collagen in connective tissue are considered to determine the individual’s elastic index. The skin surface is made up of a complex network of crossing thin lines. The two-dimensional relationship between primary and secondary lines determines the skin texture and its grade of irregularity. SG is caused by changes in the structural connective tissue due to a hormonal elect on the alignment and reduced elastin and fibrillin in the dermis. Severity scoring of SG was observed using the numerical scoring system of Atwal. This score provides a rank based on observation of four areas in which SG is most commonly observed (abdomen, hips, buttocks, and breast).
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Objective To assess the efficacy and safety of nonablative 1 565-nm Er:Glass fractional laser in the treatment of striae gravidarum.Methods The left and right sides of the abdomens of 30 subjects with striae gravidarum were divided into 2 groups by simple randomization:treatment group treated with nonablative 1 565-nm Er:Glass fractional laser every 4 weeks for 3 sessions,and control group receiving no treatment.These subjects were followed up at the baseline,4th,8th and 12th week.At the same time,photos were taken,the skin flexibility was evaluated,and the width of striae was measured.Four weeks after the final treatment,clinical improvement was evaluated by 2 doctors,who were blind to the therapeutic protocol,according to clinical photos and three-dimensional (3D) images,and satisfaction scores were also evaluated.Skin biopsies were taken from the left and right sides of the abdomens of 3 subjects,and subjected to histopathological examination.Four months after the final treatment,all the subjects were telephoned for evaluation of adverse reactions and recurrence.Results A total of 27 subjects completed the whole trial.Four weeks after the final treatment,25 (92.6％) of the 27 subjects were considered to achieve an improvement by doctors.However,21 (77.8％) of the 27 subjects considered themselves to achieve an improvement.After 3 sessions of treatment,the treatment group showed a significant decrease in the largest width of striae from 4.852 mm to 3.296 mm (P ＜ 0.001) and a significant increase in skin flexibility from 0.803 to 0.878 (P ＜ 0.001).Histopathologically,the control group showed obviously atrophic epidermis and decreased collagen and elastin in the dermis,while the treatment group showed thickened epidermis and dermis,extended rete ridges,and increased collagen and elastic fibers which arranged more regularly.Immediate adverse reactions during the treatment included erythema and edema,and other adverse reactions included mild crust,itching and post-inflammatory hyperpigmentation (PIH).PIH was improved at 4 months after the final treatment compared with that at 4 weeks after the final treatment.Conclusion The nonablative 1 565-nm Er:Glass fractional laser can markedly improve the width and appearance of striae gravidarum,and increase skin flexibility in the treatment region.
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BACKGROUND: Striae gravidarum (SG) is a common skin change that occurs in pregnancy. Various risk factors associated with SG have been reported, but the results are controversial. OBJECTIVE: This study aimed to determine the incidence, clinically associated factors, and awareness of SG in postpartum women at the dermatology clinic of a university hospital. METHODS: A questionnaire-based survey was conducted on women with fertility histories who had visited the dermatologic clinic of our hospital from October 2015 to December 2016. The survey items included the time of SG appearance, maternal age, and factors related to the development of SG (e.g., maternal weight gain, fetal weight and sex, and family history). We also investigated the awareness of SG development and treatment, and excluded subjects with various diseases that could affect SG. RESULTS: The subjects were 38 primiparas and 62 multiparas, and SG was observed in 91 subjects (91%). In 55.9% of the primiparous women, the SG became evident in the second trimester, although 63.1% of the multiparous women experienced the development of SG in the third trimester. There was a statistically significant difference in the time of SG appearance between primiparas and multiparas. In addition, fetal weight, maternal weight gain, and family history of SG were statistically associated with the occurrence of SG. However, fetal sex was not related to SG. The pregnant women considered the weight gain during pregnancy to be the most common cause of SG, while family history, fetal overweight, and the use of cream for skin regeneration were thought to be other causes of SG. 53.8% of the subjects with SG experienced various treatment methods, which did not show any significant difference in terms of effectiveness when compared with non-treated subjects. CONCLUSION: In our study, maternal weight gain, family history, and fetal weight were statistically significantly associated with the development of SG. We believe that this study may be useful to enhance our understanding of the awareness, prevalence, and related factors of SG in dermatologic outpatients at a university hospital. Multi-center studies with large numbers of patients are warranted to further investigate the clinical features of SG.