Abstract
OBJECTIVES: to analyze the Pelvic Floor Muscle Strength (PFMS) of pregnant women with one or more vaginal or cesarean deliveries; to compare the PFMS of these with pregnant women with the PFMS of primiparous women. METHODS: cross-sectional study with women up to 12 weeks pregnant, performed in Itapecerica da Serra, São Paulo state, from December 2012 to May 2013. The sample consisted of 110 pregnant women with one or more vaginal deliveries or cesarean sections and 110 primigravidae. The PFMS was evaluated by perineometry (Peritron(tm)) and vaginal digital palpation (modified Oxford scale). RESULTS: the average PFMS in pregnant women with a history of vaginal delivery or cesarean section was 33.4 (SD=21.2) cmH2O. From the Oxford scale, 75.4% of the pregnant women with previous vaginal or cesarean deliveries presented grade ≤ 2, and 5.5% grade ≥ 4; among the primiparae, 39.9% presented grade ≤ 2, and 50.9% grade ≥ 4, with a statistically significant difference (p<0.001). From the perineometry, there was no statistically significant difference between the PFMS and age, type of delivery, parity, body mass index, and genitourinary tract symptoms, however, there was a statistically significant difference between the pregnant women with and without a history of episiotomy (p=0.04). In the palpation, none of the variables showed a statistically significant difference. CONCLUSION: pregnancy and childbirth can reduce the PFMS.
Highlights
The pregnancy, type of delivery, perineal conditions, and parity may influence the pelvic floor muscle strength (PFMS), causing morbidities of the genitourinary urinary tract and a negative effect in relation to the sexual, physical, psychological, and social health of the woman[1,2].A study that evaluated the quality of life in 77 women with urinary incontinence (UI) 90 days after childbirth identified the most common symptoms as: micturition frequency (88.3%), nocturia (87%) and urge incontinence (54.5%)
The results showed that the PFMS did not change significantly during the pregnancy nor in the puerperium (ANOVA: p =0.78), with a prevalence of weak intensity PFMS
The study population consisted of pregnant women who met the following inclusion criteria: one or more previous vaginal or caesarean deliveries; up to 12 weeks of gestation; without previous abdominal or urogenital surgery; without diseases that could interfere with the PFMS; without difficulty in communicating due to decreased hearing acuity or impaired speech
Summary
The pregnancy, type of delivery, perineal conditions, and parity may influence the pelvic floor muscle strength (PFMS), causing morbidities of the genitourinary urinary tract and a negative effect in relation to the sexual, physical, psychological, and social health of the woman[1,2].A study that evaluated the quality of life in 77 women with urinary incontinence (UI) 90 days after childbirth identified the most common symptoms as: micturition frequency (88.3%), nocturia (87%) and urge incontinence (54.5%). The pregnancy, type of delivery, perineal conditions, and parity may influence the pelvic floor muscle strength (PFMS), causing morbidities of the genitourinary urinary tract and a negative effect in relation to the sexual, physical, psychological, and social health of the woman[1,2]. A cohort study identified an increased prevalence of UI that remained for one year after delivery, among primiparae, compared to women with no previous births[4]. A prospective cohort study, conducted with 110 primiparae, compared the means of PFMS during the pregnancy and after delivery, using perineometry and vaginal digital palpation. These primiparae were followed at four moments: up to 12 weeks of gestation; between 36 and 40 weeks of gestation; between 42 and 60 days after the delivery. The study found that there was no statistically significant difference in relation to maternal age, race, marital status, dyspareunia, nutritional status, stool characteristics, type of delivery, perineal conditions, and weight of the newborn[5]
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