Stress urinary incontinence in relation to pelvic floor muscle strength and associated factors in the third trimester of pregnancy: A cross-sectional study

Astrid Yunita,Tyas Priyatini

doi:10.12688/f1000research.20220.1

Astrid Yunita, Tyas Priyatini

Open Access

https://doi.org/10.12688/f1000research.20220.1

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Abstract

Background: Many predictors of stress urinary incontinence (SUI) during pregnancy have been investigated. However, no studies have specifically identified a cutoff for pelvic floor muscle (PFM) strength and associated factors that could predict SUI during pregnancy. The aim of this study was to identify the cutoff between PFM strength and SUI, late in the third trimester of pregnancy and associated factors in Indonesian women. Methods: A cross-sectional study was conducted involving 142 women with a pregnancy of 36–40 weeks of gestational age at the Obstetrics and Gynecology clinic of Tebet Subdistrict Hospital, Jakarta, Indonesia. The data were collected through a medical interview, Questionnaire for Urinary Incontinence Diagnosis, physical examination, perineometer, and cough test. Results: SUI was identified in 54.2% of the 142 women. PFM strength 25.5 cmH2O and estimated fetal weight (EFW) ³3,100 g were the factors with the greatest influence on SUI (odds ratio (OR) = 2.52, p = 0.021, and OR = 3.34, p = 0.001, respectively). For women with PFM strength £25.5 cmH2O and EFW ³3,100 g, the prediction for SUI was ~75.39%. Conclusion: Weakening of the PFMs and EFW influence SUI. The cutoff values identified for both variables may be helpful for predicting SUI late in pregnancy.

Highlights

Stress urinary incontinence (SUI) is defined by the International Continence Society as the involuntary loss or leakage of urine[1], and is the most common type of urinary incontinence (UI) in pregnant women
Oliveira et al.[4] reported that performing pelvic floor muscle exercises (PFMEs) significantly increased pelvic floor muscle (PFM) pressure and strength during pregnancy, and another study reported that this effect was maintained postpartum[9]
Questionnaire for Urinary Incontinence Diagnosis (QUID) was designed to classify the type of urinary incontinence (SUI, urge urinary incontinence and mixed urinary incontinence), while the cough test strengthened the identification of women with stress urinary incontinence (SUI)

Summary

Introduction

Stress urinary incontinence (SUI) is defined by the International Continence Society as the involuntary loss or leakage of urine[1], and is the most common type of urinary incontinence (UI) in pregnant women. The severity of SUI tends to become more pronounced as the pregnancy progresses because of the growth of the uterus, hormonal influences, and biomechanical alterations of the pelvis. As a result, both muscle tone and muscle strength in the pelvic region may decrease during pregnancy[2]. No studies have identified a cutoff for pelvic floor muscle (PFM) strength and associated factors that could predict SUI during pregnancy. The aim of this study was to identify the cutoff between PFM strength and SUI, late in the third trimester of pregnancy and associated factors in Indonesian women. The cutoff values identified for both variables may be helpful for predicting SUI late in pregnancy

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