Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints

Abstract

To describe the mobility of the anterior pelvic compartment and hiatal enlargement measures in pregnancy with urinary stress incontinence complaints and their relation to the perceived subjective urinary incontinence severity. Forty-six pregnant women were included in this observational prospective cohort study, the ultrasonographic parameters of the pelvic anterior compartment including hiatal anteroposterior (AP) diameter, retrovesical angle (RVA), bladder neck descent (BND), urethral rotation angle (URA) and cystocele level were compared with the subjective urinary complaints in healthy third trimester pregnant women. Hiatal AP diameter, RVA and BND on Valsalva did not significantly correlate with gestational week (p=0.292, r=0.096; p=0.079, r=0.159; p=0.901, r=0.011, respectively). Urethral rotation angle was significantly increased in women after 39th gestational week (p=0.037, t=-2.17). Hiatal AP diameter, BND and RVA on maximal Valsalva did not differ with estimated fetal weight above and below 3000 gr. Total severity and bother scores of the M-ISI scale was found as similar among women with open (>1400) RVA and intact (<1400) RVA (p=0.556 and p=0.779, respectively). Only nocturia frequency (β=.379, t=4.035, p=.000) positively predicted the incontinence severity score. The pelvic floor ultrasound parameters of the anterior compartment may not predict the subjective urinary incontinence severity in third trimester of pregnancy. Nocturia was found to contribute for subjective impaired urinary function. The idea of being pregnant may suppress the general complaints related with changes in pelvic floor mobility.