Impact of childbirth and mode of delivery on vaginal resting pressure and on pelvic floor muscle strength and endurance

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• 作者：Gunvor Hilde ; PT^a ; ^b ; Jette Stæ ; r-Jensen ; MD^a ; Franziska Siafarikas ; MD^a ; ^c ; Marie Ellströ ; m Engh ; PhD ; MD^a ; ^c ; Ingeborg Hoff Bræ ; kken ; PhD ; PT^a ; Kari Bø ; PhD ; PT^a ; ^b
• 关键词：mode of delivery ; pelvic floor muscle strength and endurance ; pregnancy and childbirth ; urinary incontinence ; vaginal resting pressure
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：208
• 期：1
• 页码：50.e1-50.e7
• 全文大小：287 K

文摘

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Objective

We sought to study impact of delivery mode on vaginal resting pressure (VRP) and on pelvic floor muscle (PFM) strength and endurance, and whether these measurements differed in women with and without urinary incontinence.

Study Design

We conducted a cohort study following 277 nulliparous women from midpregnancy to 6 weeks postpartum. Manometer was used for PFM measurements; differences were analyzed by t test (within groups) and analysis of variance (between groups).

Results

Only VRP changed significantly (10 % reduction, P = .001) after emergency cesarean section. After normal and instrumental vaginal delivery, VRP was reduced by 29 % and 30 % ; PFM strength by 54 % and 66 % ; and endurance by 53 % and 65 % , respectively. Significant differences for all PFM measures (P < .001) were found when comparing cesarean vs normal and instrumental vaginal delivery, respectively. Urinary continent women at both time points had significantly higher PFM strength and endurance than incontinent counterparts (P < .05).

Conclusion

Pronounced reductions in VRP and in PFM strength and endurance were found after vaginal delivery. Continent women were stronger than incontinent counterparts.