CHANGES OF PELVIC FLOOR MUSCLE FUNCTION DURING PREGNANCY

Authors

  • Márta HOCK University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary. *Corresponding author: hock.marta@etk.pte.hu https://orcid.org/0000-0001-6068-6858
  • Péter TARDI University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary. https://orcid.org/0000-0002-5091-7373
  • Eszter AMBRUS Thermal Rehabilitation Center Harkány, Division of Physiotherapy, Hungary. https://orcid.org/0000-0002-2667-3356
  • Anett TÓVÁRI Railway Occupational Health Public Non-Profit Company, Harkány, Hungary.
  • Brigitta HAJNAL University of Pécs, Department of Languages for Specific Purposes, Faculty of Medicine, Pécs, Hungary.
  • Brigitta SZILÁGYI University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary. https://orcid.org/0000-0003-1432-1553
  • Eleonora LEIDECKER University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary.
  • Bálint MOLICS University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary.
  • Melinda JÁROMI University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary.
  • János KRÁNICZ University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary.
  • József BÓDIS University of Pécs, Pécs, Department of Obstetrics and Gynaecology, Faculty of Medicine, Hungary. https://orcid.org/0000-0003-0597-9097
  • Pongrác ÁCS University of Pécs, Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, Pécs, Hungary. https://orcid.org/0000-0002-4999-7345

DOI:

https://doi.org/10.24193/subbeag.64(2).15

Keywords:

pelvic floor muscle strength, endurance, vaginal wind, pregnancy.

Abstract

Objective: It is known, that incontinence rarely develops during pregnancy. The authors examined pelvic floor muscle function changes during pregnancy. Study Design: Authors examined 156 women and performed vaginal squeeze pressure measurements. Statistical data were analyzed by t-test, differences were considered to be significant at p<0.05. Results: Significant difference was found concerning maximum voluntary contraction (p=0.002) and duration of maximum muscle contraction (p=0.012) in young nulliparous women compared to average results of pregnant women. This result can be proved in young nulliparous women and among pregnant women in the 2nd (p=0.045), and 3rd trimesters (p=0.005). Comparing only the results of pregnant women a significantly decreased pelvic floor muscle strength was observed (p=0.032) in women exercising occasionally. Significantly weaker muscle strength was demonstrated in those young nulliparous women (n=21) who experienced vaginal wind (p=0.003) than in young nulliparous women without symptoms. Conclusions: Vaginal contraction strength decreases during pregnancy.

References

Amaro, J., Gameiro, M., Sousam V. et al. (2010). Comparative study of pelvic floor muscle evaluation in nuliparous and primiparous women. A prospective trial. Journal of Urology, 183:682.

Amaro, J., Moreira, E., Gameiro, M. et al. (2005). Pelvic floor muscle evaluation in incontinent patients. International Urogynecology Journal and Pelvic Floor Dysfunction, 16:352–4. 10.1007/s00192-004-1256-3.

Arya, L.A., Jackson, N.D., Myers, D.L. et al. (2001). Risk of new-onset urinary incontinence after forceps and vacuum delivery in primiparous women. American Journal of Obstetrics and Gynecology, 185:1318-24.

Bo, K., Borgen, J.S. (2001). Prevalence of stress and urge urinary incontinence in elite athletes and controls. Medicine and Science in Sports and Exercise's, 33:1797-1802.

Borello-France, D., Burgio, K.L., Richter, H.E. et al. (2006). Fecal and Urinary incontinence in primiparous women. Obstetrics and Gynecology, 108:863-72.

Burgio, K.L., Zyczynski, H., Locher, J.L. et al. (2003). Urinary incontinence in the 12- month postpartum period. Obstetrics and Gynecology, 102:1291-98.

Capson, A.C., Nashed, J., Mclean, L. (2011). The role of lumbopelvic posture in pelvic floor muscle activation in continent women. Journal of Electromyography and Kinesiology, 21:166-177.

Demirci, F., Ozden, S., Alpay, E. et al. (2001). The effects of vaginal delivery and cesarean section on bladder neck mobility and stress urinary incontinence. International Urogynecology Journal and Pelvic Floor Disorders, 12:129–133.

Dimpfl, T., Jaeger, C., Mueller-Felber, W. et al. (1998). Myogenic changes of the levator ani muscle in premenopausal women: the impact of vaginal delivery and age. Neurourology and Urodynamics, 17:197–205.

Dimpft, T., Müller-Felber, W., Anthuber, C. (1996). Histomorphology of the pelvic floor muscle under specific consideration of age and parity. Neurourology and Urodynamics, 15:333-334.

Dixon, J., Gosling, J. (1994). Histomorphology of the pelvic floor muscle. In: Schussler B, Laycock J, Norton P, Stanton S, editors. Pelvic floor reeducation: principles and practice. New York: Springer-Verlag.

Farrell, S.A., Allen, V.M., Baskett, T.F. (2001). Parturition and urinary incontinence in primiparas. Obstetrics and Gynecology, 97:350-56.

Foldspang, A., Mommsen, S., Djurhuus, J.C. (1999). Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth, and obstetric techniques. American Journal of Public Health, 89:209–212.

Gameiro, M.O., Sousa, V.O., Gameiro, L.F. et al. (2011). Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women: a prospective study. Clinics, 66:1389–1393, doi: 10.1590/S1807-59322011000800014.

Hadar, H., Kornreich, L., Heifettz, M. et al. (1991). Air in vagina. Indicator of intrapelvic pathology on CT. Acta Radiologica, 32:170–173.

Hvidman, L., Foldspang, A., Mommsen, S. et al. (2002). Correlates of urinary incontinence in pregnancy. International Urogynecology Journal and Pelvic Floor Dysfunction, 13:278–283.

Iosif, C.S., Batra, S., Ek, A. et al. (1981). Estrogen receptors in the human female lower urinary tract. American Journal of Obstetrics and Gynecology, 141:817-820.

Iosif, S. (1981). Stress incontinence during pregnancy and puerperium. International Journal of Gynaecology and Obstetrics, 19:13–20.

Krissi, H., Medina, C., Stanton, S.L. (2003). Vaginal wind – a new pelvic symptom. International Urogynecology Journal, 14:399-402.

Madill, S.J., McLean, L. (2008). Quantification of abdominal and pelvic floor muscle synergies in response to voluntary pelvic floor muscle contractions. Journal of Electromyography and Kinesiology, 18:955–964.

Manson, L., Rose, B., Wrong, H. et al. (2010). The role of antenatal pelvic floor muscle exercises in prevention of postpartum stress incontinence: a randomized controlled trial. Journal of Clinical Nursing, 19: 2777-2786.

McArdle WD, Katch F, Katch C, editors. (1991). Exercise Physiology: Energy, Nutrition and Human Performance. 3rd ed. Philadelphia, PA and London, UK: Lea & Febiger.

Meyer, S., Schreyer, A., De Grandi, P. et al. (1998). The effects of birth on urinary continence mechanisms and other pelvic-floor characteristics. Obstetrics and Gynecology, 92:613-18.

Morkved, S., Salvesen, K.A., Bo, K. et al. (2004). Pelvic floor muscle stregth and thickness in continent and incontinent nulliparous pregnant women. International Uroginecology Journal, 15:384-390.

Nguyen, J.K., Lind, L.R., Choe, J.Y. et al. (2000). Lumbosacral spine and pelvic inlet changes associated with pelvic organ prolapsed. Obstetrics and Gynecology, 95:332-336.

Nygaard, I.E., Thompson, F.L., Svengalis, S.L. et al. (1994). Urinary incontinence in elite nulliparous athletes. Obstetetrics and Gynecology, 84:183-187.

O’Sullivan, P.B., Beales, D.J. (2007). Changes in pelvic floor and diaphragm kinematics and respiratory patterns in subjects with sacroiliac joint pain following a motor learning intervention: A case series. Manual Therapy, 12:209–218.

Peruchini, D., DeLancey, J.O.L. (2008). Functional Anatomy of the Pelvic Floor and Lower Urinary Tract. In: Baussler K, Shussler B, Burgio KL, Moore KH, Norton PA, Stanton S, editors. Pelvic Floor Re-education. 2nd ed. London, UK: Springer.

Peschers, U.M., Sultan, A.H., Jundt, K. et al. (2003). Urinary and anal incontinence after vacuum delivery. European Journal of Obstetrics and Gynecology Reproductive Biology, 110:39-42.

Powers, S., Howley, E. (Eds). (2007). Exercise Physiology: Theory and application to fitness and performance. 6th ed. New York, NY: McGraw Hill.

Rortveit, G., Daltveit, A.K., Hannestadt, Y.S. et al. (2003). Urinary incontinence after vaginal delivery or cesarean section. New England Journal of Medicine, 348:900-907.

Royal College of Obstetricians and Gynaecologists. (2008, December 3). Exercise in pregnancy. RCOG London, UK; Statement 4, Available at: www.rcog.org.uk/index.asp?PageID=1366.

Sampselle, C.M. (1990). Pelvic muscle strength changes and stress urinary incontinence associated with childbirth. Journal of Nurse Midwifery, 35:371-77.

Sapsford, R. (2004). Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Manual Therapy; 9:3–12.

Sapsford, R.R., Hodges, P.W., Richardson, C.A. et al. (2001). Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics., 20:31–42.

Scheer, I., Thakar, R., Sultan, A.H. et al. (2007). Does pregnancy and delivery affect pelvic organ support? Pregnancy and prolapse assessement [PAPA] study. 37thAnnual Meeting of the International Continence Society (ICS) homepage on the Internet; 2007 aug 20-24; Rotherdan. Bristol:ICS;2007 cited 2008 nov 11. Avaliable from: https://www.icsoffice.org/publications/2007/pdf/0094.pdf

Slieker-ten Hove, M.C.Ph., Pool-Goudzwaard, A.L., Eijkemans, M.J.C., Steegers-Theunissen, R.P.M., Burger, C.W., Vierhout, M.E. (2009). Vaginal noise: prevalence, bother and risk factors in a general female population aged 45-85 years. International Urogynecology Journal and Pelvic Floor Dysfunction, 20:905–911.

Thyssen, H.H., Clevin, L., Olesen, S. et al. (2002). Urinary incontinence in elite female athletes and dancer. International Urogynecology Journal, 13:15-17.

Vesnes, S.L., Rortveit, G., Bo, K. et al. (2007). Urinary incontinence during pregnancy. Obstetetrics and Gynecology, 109:922-928.

Downloads

Published

2019-06-30

How to Cite

HOCK, M., TARDI, P., AMBRUS, E., TÓVÁRI, A., HAJNAL, B., SZILÁGYI, B., … ÁCS, P. (2019). CHANGES OF PELVIC FLOOR MUSCLE FUNCTION DURING PREGNANCY. Studia Universitatis Babeș-Bolyai Educatio Artis Gymnasticae, 64(2), 57–68. https://doi.org/10.24193/subbeag.64(2).15

Issue

Section

Articles

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.