Format

Send to

Choose Destination
BJOG. 2013 Oct;120(11):1423-9. doi: 10.1111/1471-0528.12321. Epub 2013 Jul 3.

How well can pelvic floor muscles with major defects contract? A cross-sectional comparative study 6 weeks after delivery using transperineal 3D/4D ultrasound and manometer.

Author information

1
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.

Abstract

OBJECTIVE:

To investigate ability to contract, vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and PFM endurance 6 weeks after vaginal delivery in primiparous women, with and without major defects of the levator ani (LA) muscle.

DESIGN:

Cross-sectional comparative study.

SETTING:

Akershus University Hospital, Norway.

SAMPLE:

A cohort of 175 singleton primiparous women delivering vaginally after more than 32 weeks of gestation.

METHODS:

Major LA defects were assessed by 3D/4D transperineal ultrasound at maximal PFM contraction, using tomographic imaging. VRP, PFM strength and PFM endurance were measured vaginally by manometer. Data were analysed by independent-samples Student's t test, chi-square test, and standard multiple and simple linear regression.

MAIN OUTCOME MEASURES:

VRP, PFM strength and PFM endurance.

RESULTS:

Of the women included in the study, 4% were not able to contract their PFM 6 weeks after delivery. Women with major LA defects (n = 55) had 47% lower PFM strength and 47% lower endurance when compared with women without major LA defects (n = 120). Mean differences were 7.5 cmH2O (95% CI 5.1-9.9, P < 0.001) and 51.2 cmH2O seconds (95% CI 32.8-69.6, P < 0.001), respectively. These estimates were unchanged by adjustment in multivariable linear regression for potentially confounding demographic and obstetric factors. No difference was found regarding VRP (P = 0.670).

CONCLUSIONS:

Women with major LA defects after vaginal delivery had pronounced lower PFM strength and endurance than women without such defects; however, most women with major LA defects were able to contract the PFM. This indicates a potential capacity by non-injured muscle fibres to compensate for loss in muscle strength, even at an early stage after delivery.

KEYWORDS:

Levator ani defects; muscle endurance; muscle strength; pelvic floor muscles; vaginal delivery; vaginal resting pressure

PMID:
23834432
DOI:
10.1111/1471-0528.12321
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center