Comparison of pelvic floor muscle strength between women undergoing vaginal delivery, cesarean section, and nulliparae using a perineometer and digital palpation

Batista, Elicéia Marcia; Conde, Délio Marques; Amaral, Waldemar Naves do; Martinez, Edson Zangiacomi

doi:10.3109/09513590.2011.569603

Cited by 27 publications

(21 citation statements)

References 25 publications

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“…Although some authors suggest that age and skin color are related to lower PFMS after childbirth 19 , in the current survey, a significant difference in PFMS was identified only in relation to education level. Primiparous women over 12 years of education and normal birth showed a significantly higher PFMS value.…”

Section: Discussioncontrasting

confidence: 92%

“…However, the authors suggest that the level of education may be associated with other factors such as socioeconomic condition, i.e. higher education, in general, is related to increased socioeconomic condition which in turn allows access to better nutrition, physical activity, and greater access to health care among others 19 . However, the socio-economic condition was not addressed in the current research, preventing more comparisons.…”

Section: Discussionmentioning

confidence: 79%

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Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study

Mendes

Oliveira

Caroci

et al. 2016

Rev. Latino-Am. Enfermagem

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Objectives: to compare the pelvic floor muscle strength in primiparous women after normal birth and cesarean section, related to the socio-demographic characteristics, nutritional status, dyspareunia, urinary incontinence, perineal exercise in pregnancy, perineal condition and weight of the newborn.Methods: this was a cross-sectional study conducted after 50 - 70 postpartum days, with 24 primiparous women who underwent cesarean delivery and 72 who had a normal birth. The 9301 PeritronTM was used for analysis of muscle strength. The mean muscle strength was compared between the groups by two-way analysis of variance. Results: the pelvic floor muscle strength was 24.0 cmH2O (±16.2) and 25.4 cmH2O (±14.7) in postpartum primiparous women after normal birth and cesarean section, respectively, with no significant difference. The muscular strength was greater in postpartum women with ≥ 12 years of study (42.0 ±26.3 versus 14.6 ±7.7 cmH2O; p= 0.036) and in those who performed perineal exercises (42.6±25.4 11.8±4.9 vs. cmH2O; p = 0.010), compared to caesarean. There was no difference in muscle strength according to delivery type regarding nutritional status, dyspareunia, urinary incontinence, perineal condition or newborn weight. Conclusion: pelvic floor muscle strength does not differ between primiparous women based on the type of delivery. Postpartum women with normal births, with higher education who performed perineal exercise during pregnancy showed greater muscle strength.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 79%

Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study

Mendes

Oliveira

Caroci

et al. 2016

Rev. Latino-Am. Enfermagem

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“…Vaginal delivery is associated with an increased rate of avulsion of puborectalis component of the levator ani muscle, and the use of forceps or vacuum also increases the damage7-8. A lower pelvic floor muscle strength was observed in women with a history of vaginal delivery compared to those undergoing Cesarean section9-10. In addition, recent studies showed that childbirth-related trauma may involve not only the levator ani muscle but also damage to fascia and connective tissue11-12.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Postpartum Women One Week after Their First Delivery

Liu¹,

Xu²,

Ying³

et al. 2014

Int. J. Med. Sci.

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This study investigated the morphology and structure of pelvic floor in 50 nulliparous and 95 postpartum women (47 vaginal delivery, 48 Cesarean section) using translabial three-dimensional (3D) ultrasound. All the primiparae underwent ultrasound examination within one week after their first delivery. Volume datasets were acquired and analyzed to determine the alterations of levator hiatus after childbirth. Significant differences were observed in the levator hiatus of postpartum women compared with that of nullipara women. In postpartum women, the levator hiatus, with their dimensions increased, expanded into a circular shape. Puborectalis was avulsed in eight cases (accounting for 8.42% of all) and pelvic organ prolapse was found in 12 cases (accounting for 12.63%). The hiatal dimensions were larger and the incidence of pubrectalis muscle avulsion (17.02% vs. 0%) and pelvic organ prolapse (21.28% vs. 4.17%) was significantly higher in Vaginal delivery group than Cesarean section group. In summary, 3D ultrasound is an effective tool to detect the pelvic floor of postpartum women who present with morphological abnormalities, and such abnormalities are more likely to show in vaginal delivery women compared to Cesarean section.

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“…Um estudo no qual se analisou a correlação entre as medidas de força muscular, realizadas por meio da palpação vaginal digital e pelo perineômetro, concluiu que a palpação vaginal é importante para ensinar a contração correta dos MAP, mas não é um método com boa reprodutividade 28 . Outros autores, no entanto, mostraram resultados semelhantes aos do presente estudo 6,13,29,30 . Assim, acredita-se que a palpação vaginal digital possa ser usada na prática clínica para medir a força dos MAP, uma vez que a maioria dos estudos mostrou boa correlação com o perineômetro.…”

Section: Discussionunclassified

“…O parto vaginal é um dos fatores de risco para essa desnervação porque, durante o segundo estágio do trabalho de parto, a cabeça fetal pode provocar compressão e alongamento do nervo pudendo, causando estiramento dos tecidos e ligamentos da pelve 3,4 . Outros estudos demonstraram que o parto vaginal pode diminuir a força muscular do assoalho pélvico de mulheres primíparas e multíparas, quando comparadas com mulheres submetidas à cesárea e nulíparas [4][5][6] . A incontinência urinária é descrita como a disfunção do assoalho pélvico mais prevalente, afetando 34 a 38% de primíparas e multíparas três meses após o parto 7 .…”

Section: Introductionunclassified

Efeito de um programa de exercícios para o fortalecimento dos músculos do assoalho pélvico de multíparas

Assis¹,

Sá²,

Amaral³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVOS: Investigar o efeito de um programa individualizado e supervisionado de exercícios para os músculos do assoalho pélvico (MAP) no pós-parto de multíparas e verificar a correlação entre dois métodos de medida de força dos MAP. MÉTODOS: Conduziu-se um ensaio clínico aberto em que foram incluídas puérperas, multíparas com idade entre 18 e 35 anos. A amostra foi de 23 puérperas divididas em dois grupos: Grupo Intervenção (GI, n=11) e Grupo Controle (GC, n=12). As puérperas do GI participaram de um programa de exercícios para os MAP durante oito semanas, com frequência de duas vezes por semana. As puérperas do GC não receberam orientação quanto à prática de exercícios. A força dos MAP foi medida em duas oportunidades, utilizando-se a palpação vaginal digital e o perineômetro. A análise estatística foi realizada através dos seguintes testes: exato de Fisher, do χ 2 , t de Student, Kolmogov-Smirnov para duas amostras e coeficiente de correlação de Pearson. Foi considerado como significativo p<0,05. RESULTADOS: A média de idade das participantes do GI foi de 24±4,5 anos e do GC foi de 25,3±4 anos (p=0,4). Após o programa de exercícios, verificou-se diferença significativa entre os grupos nas duas medidas da força muscular (p<0,001). Os dois métodos de medida da força muscular apresentaram correlação significativa nas duas avaliações (1ª avaliação: r=0,889, p<0,001; 2ª avaliação: r=0,925, p<0,001). CONCLUSÕES: O programa de exercícios resultou em aumento significativo da força dos MAP. Verificou-se boa correlação entre a palpação vaginal digital e o perineômetro, indicando que a palpação vaginal pode ser utilizada na prática clínica por ser um método de baixo custo e que demonstrou uma correlação significativa com um método objetivo, o perineômetro. Abstract PURPOSES:To investigate the effect of an individualized and supervised exercise program for the pelvic floor muscles (PFM) in the postpartum period of multiparous women, and to verify the correlation between two methods used to assess PFM strength. METHODS: An open clinical trial was performed with puerperal, multiparous women aged 18 to 35 years. The sample consisted of 23 puerperal women divided into two groups: Intervention Group (IG, n=11) and Control Group (CG, n=12). The puerperal women in IG participated in an eight-week PFM exercise program, twice a week. The puerperal women in CG did not receive any recommendations regarding exercise. PFM strength was assessed using digital vaginal palpation and a perineometer. The statistical analysis was performed using the following tests: Fisher's exact, χ 2 , Student's t, Kolmogorov-Smirnov for two samples, and Pearson's correlation coefficient. Significance was defined as p<0.05. RESULTS: The participants' mean age was 24±4.5 years in IG and 25.3±4 years in CG (p=0.4). After the exercise program, a significant difference was found between the groups in both modalities of muscle strength assessment (p<0.001). The two muscle strength assessment methods showed a significant correlation in both assessments (...

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Comparison of pelvic floor muscle strength between women undergoing vaginal delivery, cesarean section, and nulliparae using a perineometer and digital palpation

Cited by 27 publications

References 25 publications

Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study

Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study

Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Postpartum Women One Week after Their First Delivery

Efeito de um programa de exercícios para o fortalecimento dos músculos do assoalho pélvico de multíparas

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