Impact of childbirth and mode of delivery on vaginal resting pressure and on pelvic floor muscle strength and endurance

• Published in: American journal of obstetrics and gynecology Vol. 208; no. 1; pp. 50.e1 - 50.e7
• Main Authors: Hilde, Gunvor, PT, Stær-Jensen, Jette, MD, Siafarikas, Franziska, MD, Engh, Marie Ellström, PhD, MD, Brækken, Ingeborg Hoff, PhD, PT, Bø, Kari, PhD, PT
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 2013
• Subjects: Abdominal Muscles - physiology; Adult; Delivery, Obstetric; Female; Humans; mode of delivery; Muscle Contraction - physiology; Muscle Strength - physiology; Obstetrics and Gynecology; Parturition - physiology; Pelvic Floor - physiology; pelvic floor muscle strength and endurance; Postpartum Period; pregnancy and childbirth; Prospective Studies; urinary incontinence; Urinary Incontinence - physiopathology; Vagina - physiology; vaginal resting pressure; pregnancy and childbirth; pelvic floor muscle strength and endurance; vaginal resting pressure; urinary incontinence; mode of delivery
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2012.10.878

Objective We sought to study impact of delivery mode on vaginal resting pressure (VRP) and on pelvic floor muscle (PFM) strength and endurance, and whether these measurements differed in women with and without urinary incontinence. Study Design We conducted a cohort study following 277 nulliparous women from midpregnancy to 6 weeks postpartum. Manometer was used for PFM measurements; differences were analyzed by t test (within groups) and analysis of variance (between groups). Results Only VRP changed significantly (10% reduction, P = .001) after emergency cesarean section. After normal and instrumental vaginal delivery, VRP was reduced by 29% and 30%; PFM strength by 54% and 66%; and endurance by 53% and 65%, respectively. Significant differences for all PFM measures ( P < .001) were found when comparing cesarean vs normal and instrumental vaginal delivery, respectively. Urinary continent women at both time points had significantly higher PFM strength and endurance than incontinent counterparts ( P < .05). Conclusion Pronounced reductions in VRP and in PFM strength and endurance were found after vaginal delivery. Continent women were stronger than incontinent counterparts.