Antenatal Pelvic Floor Muscle Exercises Research Articles

The effect of antenatal pelvic floor muscle exercise on sexual function and labour and birth outcomes: A randomised controlled trial

BackgroundPelvic floor muscle exercises (PFME) are recommended for treatment of urinary incontinence with less evidence available about the effect on female sexual function (FSF) and childbirth. AimTo investigate the effect of antenatal PFME on FSF during pregnancy and the first three months following birth as a primary outcome, and on labour and birth outcomes as a secondary outcome. Method200 nulliparous women were randomised to control (n = 100) and intervention (n = 100) groups. The women in the intervention group (IG) undertook PFME from 20 weeks gestation until birth and had routine antenatal care, while those in the control group (CG) received routine antenatal care only. The Female Sexual Function Index (FSFI) was used to measure FSF at 36 weeks gestation and three months postnatal. Baseline characteristics and childbirth data were also collected and analysed using SPSS. ResultsThere were no statistically significant differences between the two groups in terms of FSF scores during pregnancy and on childbirth outcomes. Sexual satisfaction was slightly higher in the CG [Mean ± SD, CG: 4.35 ± 1.45 vs. IG: 3.70 ± 1.50, (P = 0.03)] at three months after birth. However, 50% of women adhered to the PFME, and 40% of women did not resume sex by three months after the birth. ConclusionThough some trends were observed, the results showed no effect of PFME on sexual function or labour and birth outcomes. This needs to be interpreted considering the 50% adherence to PFME. More research is recommended.

The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis.

The current data on the effectiveness of antenatal pelvic floor muscle exercises (PFME) on childbirth outcomes are limited. Therefore, in this study the effect of antenatal PFMEs on labour and birth outcomes was assessed by undertaking a meta-analysis. Databases were systematically searched from 1988 until June 2019. Randomised controlled trials (RCTs) and quasi-experimental studies were included. The methodological quality of studies was assessed using Cochrane Collaboration tools. The outcomes of interest were: duration of first and second stage of labour, episiotomy and perineal outcomes, mode of birth (spontaneous vaginal birth, instrumental birth and caesarean section) and fetal presentation. The mean difference (MD) and risk ratio RR) with the corresponding 95% confidence intervals (CIs) were calculated to assess the association between PFME and the childbirth outcomes. A total of 16 articles were included (n = 2,829 women). PFME shortened the duration of the second stage of labour (MD: -20.90, 95%, CI: -31.82 to -9.97, I2: 0%, p = 0.0002) and for primigravid women (MD: -21.02, 95% CI: -32.10 to -9.94, I2: 0%, p = 0.0002). PFME also reduced severe perineal lacerations (RR 0.57, 95% CI: 0.38 to 0.84, I2: 30%, p = 0.005). No significant difference was seen in normal vaginal birth, caesarean section, instrumental birth and episiotomy rate. Most of the studies carried a moderate to high risk of bias. Antenatal PFME may be effective at shortening the second stage of labour and reducing severe perineal trauma. These findings need to be interpreted considering the included studies' risk of bias. More high-quality RCTs are needed.

Evaluation of the effect of an antenatal pelvic floor muscle exercise programme on female sexual function during pregnancy and the first 3 months following birth: study protocol for a pragmatic randomised controlled trial

BackgroundSexual dysfunction can have a negative impact on women’s quality of life and relationships. There is limited information about female sexual function and treatment, particularly during pregnancy and the postpartum period. The effect of pelvic floor muscle exercise (PFME) on sexual function (SF) has not been studied adequately. The purpose of this study is to investigate the effect of antenatal PFME on female SF during pregnancy and the first 3 months following birth.Methods/designThis is a pragmatic, randomised controlled trial which will compare a structured antenatal PFME programme combined with standard antenatal care to standard antenatal care alone. Eligible women who are less than 22 weeks’ gestation will be recruited from the antenatal clinics of one hospital located in Western Sydney, Australia. A sample of 200 primiparous pregnant women who meet the inclusion criteria will be randomised to either control or intervention groups. This sample size will allow for detecting a minimum difference of 9% in the female SF score between the two groups. The duration of the PFME programme is from approximately 20 weeks’ gestation until birth. Female SF will be measured via questionnaires at < 22 weeks’ gestation, at 36 weeks’ gestation and at 3 months following birth. Baseline characteristics, such as partner relationship and mental health, will be collected using surveys and questionnaires. Data collected for secondary outcomes include the effect of PFME on childbirth outcomes, urinary and faecal incontinence symptoms and quality of life.DiscussionThe findings of this study will provide more information on whether a hospital-based antenatal PFME has any effect on female SF, urinary and faecal incontinence during pregnancy and the first 3 months following birth. The study will also provide information on the effectiveness of antenatal PFME on childbirth outcomes.Trial registrationAustralian New Zealand Clinical Trials registry, ACTRN12617001030369. Registered on 17 July 2017.

Effect of Antenatal Pelvic Floor Muscle Exercise on Mode of Delivery: A Randomized Controlled Trial

Background: Vaginal delivery is the best end of the pregnancy for the mother and the newborn. Aim: To evaluate the impacts of short-term antenatal pelvic floor muscle (PFM) exercises on a woman’s mode of delivery. Methods: This is a randomized controlled trial that recruited 20 healthy pregnant women aged between 20 and 25 years and able to contract the PFMs. The participants were included in the study at 20 weeks of gestation (WG) and were randomly allocated to one of two groups: the intervention group (n = 10) or the control group (n = 10). PFM strength was measured by vaginal squeeze pressure at 20 and 36 WG, and delivery outcomes were evaluated by a blinded searcher from the birth registry after labor. Results: There were no statistically significant changes between both groups at baseline regarding gestational age, type of labor, previous pregnancy complications, and PFM strength (p > 0.05). There was a significant change between both groups in mean PFM strength at 36 WG (p < 0.05). A significant correlation was observed between PFM strength at 36 WG and mode of delivery (vaginal delivery: r = 0.58, p < 0.05; caesarean delivery: r = –0.49, p < 0.05). Conclusions: PFM exercise is recommended for healthy pregnant women as a safe and inexpensive strategy for increasing the vaginal delivery rate.

Influence of antenatal pelvic floor muscle exercise on the vaginal delivery and tension of pelvic floor

Objective To observe the influence of antenatal pelvic floor muscle exercise on the vaginal delivery and tension of pelvic floor. Methods The clinical data of 90 parturients with vaginal delivery were retrospectively analyzed,all parturients were divided into two groups,each of 45 cases,The control group used routine antenatal preparation,the observation group used antenatal pelvic floor muscle exercise based on routine antenatal preparation,The labor,mode of delivery and pelvic floor muscle tension of two groups were compared. Results The labor of observation group was shorter than the control group,the natural delivery rate of observation group was 93.3%,it was significantly higher than 77.8% in control group,the tension of pelvic floor of parturients in observation group after delivery were better than the control group,there were statistically significant differences between two groups(P＜0.05). Conclusion Antenatal pelvic floor muscle exercise could help to smooth production and post-natal maternal rehabilitation,it was worthy of attention. Key words: Vaginal,Pelvic floor Tension; Muscle Hypotonia

The role of antenatal pelvic floor muscle exercises in prevention of postpartum stress incontinence: a randomised controlled trial

This article reports a randomised controlled trial to determine the efficacy of antenatal pelvic floor muscle exercises in the primary prevention of postpartum stress incontinence in primiparous women. Pelvic floor muscle exercises are effective in treating stress incontinence, yet prevention studies demonstrate equivocal findings. Randomised controlled trial. Pregnant women recruited from two hospitals in North-west England were randomised to an intervention (n = 141) or control group (n = 145). Data were collected from 2005-2006. The intervention comprised four sessions of taught pelvic floor muscle exercise training during pregnancy and 8-12 maximal contractions repeated twice daily at home. A modified Bristol Female Lower Urinary Tract Symptom questionnaire, Leicester Impact Scale and Three Day Diary were administered at 20 and 36 weeks of pregnancy and three months postpartum. The intervention group was more likely to exercise their pelvic floor muscles compared to controls at 36 weeks (p = 0.019) and three months (0.022), reporting fewer episodes of incontinence and a lower score on the Leicester Impact Scale. However, these differences were not statistically significant. Significant differences were not demonstrated between the groups in relation to incontinence episodes and degree of bother of symptoms postpartum, although trends indicate a positive effect. Further research is necessary to address issues of adherence and the effect of pelvic floor muscle exercise undertaken during pregnancy on postpartum stress urinary incontinence. A proportion of women did not meet the required attendance at antenatal class, furthermore, few exercised their pelvic floor muscles during pregnancy according to instructions. Health professionals need to find ways to instruct and motivate women to perform pelvic floor muscles exercises regularly during pregnancy and the postpartum.

A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence

the aim of the study was to evaluate the effect of antenatal pelvic floor muscle exercise (PFME) in the prevention and treatment of urinary incontinence during pregnancy and postpartum period. three hundred women were randomly assigned to the PFME group and control group. Urinary symptoms were measured by Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and question of self-reported urinary incontinence. Questionnaire scores of the PFME and the control groups were compared and analyzed. during late pregnancy and the postpartum period, the PFME group had significantly lower total UDI-6 and IIQ-7 scores; their self-report rate of urinary incontinence was also less than the control group. Additionally, we found whether in PFME or control, women who delivered vaginally were more likely to develop postpartum urinary leakage than women who delivered by cesarean section. PFME applied in pregnancy is effective in the treatment and prevention of urinary incontinence during pregnancy, and this effect may persist to postpartum period.

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth.

Objectives The primary objective of this review was to determine, from the available evidence, the effectiveness of an antenatal and/or a post-natal program of pelvic floor muscle exercises (PFME) compared with usual care on preventing, reducing or resolving the incidence and severity of stress incontinence, urge incontinence or mixed stress and urge urinary incontinence following childbirth. Secondary objectives were included to examine the effectiveness of a PFME program on pelvic floor muscle strength and on encouraging adherence to an exercising program. Inclusion criteria Types of studies Randomised controlled trials and non-randomised controlled trials were included in the review if, in relation to urinary incontinence, and/or adherence to a PFME program, and/or pelvic floor muscle strength, the following had been explored: • antenatal PFME compared with usual care; • post-natal PFME compared with usual care; • a PFME program compared with usual care. Usual care is commonly used to describe the care women normally receive from health professionals in the antenatal and/or post-natal period. In some cases usual care includes a standard information package given to all women attending the health service and in others it is advice about performing PFME. Types of participants Participants included women who experienced a spontaneous onset of labour and who subsequently delivered at more than 20 weeks gestation either vaginally, both spontaneous and assisted, or by non-elective caesarean section. Exclusions: • women who delivered by elective caesarean section; • women experiencing post-partum overflow urinary incontinence. Types of interventions 1 Pelvic floor muscle exercises. 2 PFME instruction and a PFME program's components, such as educational materials, feedback (including biofeedback, e.g. information about strength of pelvic floor muscle contractions by various means) and number of PFME. Exclusions: • electrical stimulation of pelvic floor muscles; • vaginal cones; or • other adjunct therapies. In studies that included a subgroup treated with one of these interventions, the results of the subgroup were excluded from the review's analysis. Types of outcome measures Outcomes that were of interest: • non-occurrence of urinary incontinence following childbirth; • a change in the frequency, duration or severity (as appropriate) of urinary incontinence up to 12 months following childbirth. • a change in the strength of pelvic floor muscle contractions; • period of time PFME continued after initial instruction; • frequency of PFME undertaken; • women's awareness of the importance of PFME; • satisfaction with PFME instruction. Search strategy All major electronic sources of information relevant to the topic (e.g. PubMed, CINAHL and the Cochrane Library) were searched to identify published and unpublished studies and previous work in the field. Printed journals were handsearched and reference lists checked for potentially useful research. The review included any studies undertaken between 1981 and 2003. The search did not attempt to locate unpublished research before 1991. Assessment of quality An independent Review Panel carried out quality assessment of studies. Two members of the panel, using quality assessment checklists developed for the review, reviewed each study. Disagreements between reviewers were resolved through discussion or a third reviewer examining a study. Data extraction and analysis A data extraction tool was developed to extract data relating to participant characteristics, study methods, interventions and outcomes. Two reviewers independently extracted the required data. Randomised controlled trials included in the review were pooled in several metaanalyses using RevMan software program. Heterogeneity between studies was determined to ensure that they were sufficiently similar to allow for the pooling of their results. Non-randomised controlled trials were discussed in narrative comparisons. TRUNCATED AT 600 WORDS

Effectiveness of pelvic floor exercises in treating Urinary Incontinence following childbirth

Objectives The objective of this review is to determine from the available evidence the effectiveness of pelvic floor muscle exercises (PFME) in treating urinary incontinence following childbirth. Questions The specific questions being asked are: • Do antenatal PFME prevent or reduce urinary incontinence following childbirth? • Do PFME following childbirth resolve or reduce subsequent urinary incontinence? • What is the most effective type of instruction of PFME in treating urinary incontinence? Criteria for considering studies for this review Types of participants Women who have delivered at more than 20 weeks gestation and who have experienced a spontaneous onset of labour. The labour may proceed to a caesarean section. Exclusions: Women who have had an elective caesarean section. Studies have demonstrated that there is a lower prevalence of incontinence in women who have undergone an elective caesarean section as no stress has been placed on the pelvic floor muscles Types of interventions a) Pelvic floor exercises b) Type of instruction of PFME e.g. timing, method, content. Exclusion: Electrical stimulation of pelvic floor muscles or other adjunct therapies. These have been excluded as they are not normally performed by midwives, but rather are part of the physiotherapist’s role. Types of outcome measures Outcomes that are of interest include but are not confined to: Resolution or reduction in (as appropriate) amount, length, or severity of urinary incontinence up to twelve months following childbirth. In relation to types of instruction: • effectiveness of pelvic floor contraction • period of time PFME continued after initial instruction • frequency of PFME undertaken • woman’s awareness of importance of PFME • satisfaction with instruction

The Relationship between Ante-natal Pelvic Floor Muscle Exercises and Post-partum Stress Incontinence

Background and Purpose The present study was undertaken to investigate whether there is any relationship between ante-natal pelvic floor muscle exercises (PFME) and post-partum stress incontinence. Methods Questionnaires were sent out at 34 weeks of pregnancy, and at eight weeks post-partum, to all women booked in at two hospitals in the North West of England. At 34 weeks, 717 women out of 918 who were sent the questionnaire responded (78%). At eight weeks post-partum, 572 women out of 894 women who were sent a questionnaire returned it (64%). The questionnaires were used to determine the prevalence of reported symptoms of stress incontinence and the frequency with which the women performed PFME. Maternal and obstetric data were obtained from every participant's medical record. The SPSS PC statistical package was used to determine relationships between PFME and stress incontinence, and to look for any differences between exercisers and non-exercisers. Results Women who performed ante-natal PFME several times per week, or on a daily basis, were less likely to report stress incontinence following delivery in comparison to women who exercised infrequently. Women who did not exercise their pelvic floor muscles were also less likely to report stress incontinence compared to infrequent exercisers. Exercisers were found to differ from non-exercisers with respect to a number of maternal and obstetric variables. Conclusions There appears to be a relationship between ante-natal PFME and post-partum stress incontinence: women who exercise daily or several times per week are significantly less likely to report symptoms of stress incontinence (χ2 = 14.5, df = 1, p = 0.006). This has implications for the provision of instruction in PFME to women during their child-bearing years. The present study was undertaken to investigate whether there is any relationship between ante-natal pelvic floor muscle exercises (PFME) and post-partum stress incontinence. Questionnaires were sent out at 34 weeks of pregnancy, and at eight weeks post-partum, to all women booked in at two hospitals in the North West of England. At 34 weeks, 717 women out of 918 who were sent the questionnaire responded (78%). At eight weeks post-partum, 572 women out of 894 women who were sent a questionnaire returned it (64%). The questionnaires were used to determine the prevalence of reported symptoms of stress incontinence and the frequency with which the women performed PFME. Maternal and obstetric data were obtained from every participant's medical record. The SPSS PC statistical package was used to determine relationships between PFME and stress incontinence, and to look for any differences between exercisers and non-exercisers. Women who performed ante-natal PFME several times per week, or on a daily basis, were less likely to report stress incontinence following delivery in comparison to women who exercised infrequently. Women who did not exercise their pelvic floor muscles were also less likely to report stress incontinence compared to infrequent exercisers. Exercisers were found to differ from non-exercisers with respect to a number of maternal and obstetric variables. There appears to be a relationship between ante-natal PFME and post-partum stress incontinence: women who exercise daily or several times per week are significantly less likely to report symptoms of stress incontinence (χ2 = 14.5, df = 1, p = 0.006). This has implications for the provision of instruction in PFME to women during their child-bearing years.