Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial

Dias, Letícia Alves Rios; Driusso, Patrícia; Aita, Daniella L. C. C.; Quintana, Silvana Maria; Bø, Kari; Ferreira, Carmen V.

doi:10.1590/s1413-35552011005000011

Cited by 51 publications

(50 citation statements)

References 24 publications

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“…The results showing that PFM strength and endurance did not influence delivery outcome support findings from three previous randomized controlled trials in which there were no deleterious impact on variables between women assigned to PFMT or controls [5,6,17]. In one study fewer had deliveries with prolonged second stage in the PFM training group and there were no differences in operative vaginal delivery, episiotomy, 3 rd or 4 th degree tears, epidural analgesia or oxytocin augmentation [5].…”

Section: Discussionsupporting

confidence: 81%

Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women

et al. 2013

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Introduction and hypothesis: Theoretically, tight or strong pelvic floor muscles may impair the progress of labor and lead to instrumental deliveries. We aimed to investigate whether vaginal resting pressure, pelvic floor muscle strength or endurance at mid-pregnancy affect delivery outcome. Methods: this was a prospective cohort study of women giving birth at a university hospital. Vaginal resting pressure, pelvic floor muscle strength and endurance in 300 nulliparous pregnant women were assessed at mean gestational week 20.8 (±1.4) using a high precision pressure transducer connected to a vaginal balloon. Delivery outcome measures (acute cesarean section, prolonged second stage of labor (> 2 hours), instrumental vaginal delivery (vacuum and forceps), episiotomy and 3 rd and 4 th degree perineal tear) were retrieved from the hospital's electronic birth records. Results: Twenty-three women were lost to follow-up, mostly because they gave birth at another hospital. Women with prolonged second stage had significantly higher resting pressure than women with second stage less than 2 hours; mean difference 4.4 cm H 2 O (95% CI: 1.2-7.6), p<0.01, aOR: 1.049 (95% CI: 1.011-1.089, p=0.012). Vaginal resting pressure did not affect other delivery outcomes. Pelvic floor muscle strength and endurance similarly were not associated with any delivery outcomes. Conclusions: While mid-pregnancy vaginal resting pressure is associated with prolonged second stage of labor, neither vaginal resting pressure nor pelvic floor muscle strength or endurance are associated with operative delivery or perineal tears. Strong pelvic floor muscles are not disadvantageous for vaginal delivery.

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Section: Discussionsupporting

confidence: 81%

Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women

et al. 2013

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“…Beckmann CR et al also reported lesser need of oxytocin augmentation. 20 Meconium stained liquor was less frequent in the study group (13.11%) as compared to control group (41%) which was found to be statistically significant, similar results shown in a study by Clapp 18,23,27,[30][31][32] Mean birth weight was higher in study group than control group which was found to be statistically significant. Agur et al and Hatch MC et al also reported greater weight among new-borns in their training group.…”

Section: Labour Outcomessupporting

confidence: 82%

“…Barakat R and Dias et al also didn't find any differences regarding gestational age at birth. 17,18 Median maternal weight was more in study group than control group which was found to be statistically significant. A study by Price BB et al showed no significant differences in weight gain during pregnancy.…”

Section: Labour Outcomesmentioning

confidence: 78%

Effect of antenatal exercises on pulmonary functions and labour outcome in uncomplicated primigravida women: a randomized controlled study

Jain¹,

Srivastava

Goel

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Background: Physical fitness could influence pulmonary functions, labour and neonatal outcomes in pregnancy. The present study was undertaken to evaluate the effect of antenatal exercises on pulmonary functions and labour outcomes. Methods: Study included 122 uncomplicated primigravida in age group of 18-35 years at 24 th -28 th week of gestation were randomly allocated into study and control groups. Antenatal exercises were performed by study group for a minimum of 3 days a week for 20 minute duration till their delivery. Pulmonary function tests (PFTs) were done for all subjects at 24 th week of gestation and after 36 th week of gestation. Results: A significant improvement in FEV1, FVC, FEF25-75%, MEF50%, MIF50% and MVV between 24 & 36 weeks was observed in the study group after exercises. In study group 85.24% patients had spontaneous onset of labour, 14.8% patients had induction of labour as compared to 75.4% and 24.6% respectively in control group, however statistically insignificant. In the study group 41.67% patients did not require augmentation compared to 22.95% in the control group. In study group 13.11% patients had meconium stained liquor which was significantly less in comparison to 41% patients in the control group. Mean duration of first, second and third stage of labour was shorter in study group than control group. In study group 96.72% had normal and none had instrumental vaginal delivery compared to 88.52% and 6.6% from control group respectively. Caesarean section rate was 3.3% in study group and 4.9% in control group. APGAR score was normal in all the neonates. Fetal weight gain, birth weight, birth length and head circumference was significantly higher and NICU stay was significantly lesser in study group compared to control group. Conclusions: Antenatal exercises lead to improvement of pulmonary functions and hence labour and neonatal outcomes

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“…Few studies used PFMT aiming birth outcomes. [11][12][13][14][15][16][17][18] Du et al in a systematic review with meta-analysis found that PFMT during pregnancy was effective in reducing the time of the first and second stages of labor in primiparae. 10 In contrast, it was not found significant association between antenatal PFMT with the reduction in episiotomy rates, need for instrumental vaginal delivery and a reduction at the risk of perineal laceration.…”

Section: Introductionmentioning

confidence: 99%

Effects of antenatal pelvic floor preparation techniques on the perineal integrity: a randomized controlled trial protocol

et al. 2016

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Background: The objective of the present study was to compare the effects of perineal massage, vaginal dilator and pelvic floor muscles training on the perineal integrity of primiparae women. Methods: Primigravidae women over 18 years old will be selected, from the 32th gestational week and wishing to have a vaginal delivery.Pregnant women will be randomly allocated from a sequence generated by a computer program into three groups: perineal massage, vaginal dilator and pelvic floor muscles training. The technique should be practiced from the 34th week of pregnancy until the beginning of labor. Randomization will be done by a researcher who was not involved with the recruitment, assessment and treatment of the participants. All participants will undergo a clinical and functional assessment of the pelvic floor before the beginning of the technique practice, as well as a reassessment of these items and an assessment of perineal integrity between 45 and 60 days after delivery for a blind physiotherapist regarding the interventional procedures. The evaluative procedures will be done by a ‘blinded’ physiotherapist in relation to the intervention procedures. The outcome will be determined by the perineal integrity by the presence or absence of perineal laceration as well as their characteristics observed immediately after delivery. Conclusions: The knowledge of the effects of antenatal pelvic floor preparation techniques on the perineal integrity and pelvic floor muscles function after delivery, will allow a better choice about which approach is the best to pregnant women to prevent perineal trauma.

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Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial

Cited by 51 publications

References 24 publications

Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women

Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women

Effect of antenatal exercises on pulmonary functions and labour outcome in uncomplicated primigravida women: a randomized controlled study

Effects of antenatal pelvic floor preparation techniques on the perineal integrity: a randomized controlled trial protocol

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