477: Electrical activity of uterine, abdominal and pelvic floor muscles during human parturition

Objective.The objective of this study was to compare the role of the pelvic floor muscles between nulliparous and multiparous women in the third trimester of pregnancy, by analyzing the relationship between electrical activity (surface electromyography—EMG), vaginal palpation (modified Oxford scale), and perineal distensibility (Epi-no).Methods.This was an observational cross-sectional study on a sample of 60 healthy pregnant women with no cervical dilation, single fetus, gestational age between 35 and 40 weeks, and maternal age ranging from 15 to 40 years. The methods used were bidigital palpation (modified Oxford scale, graded 0–5), surface EMG (electrical activity during maximal voluntary contraction), and perineal distensibility (Epi-no device). The Pearson correlation coefficient (r) was used to analyze the Epi-no values and the surface EMG findings. The Kruskal-Wallis test was used to compare the median values from surface EMG and Epi-no, using the modified Oxford scale scores.Results.Among the 60 patients included in this study, 30 were nulliparous and 30 multiparous. The average maternal age and gestational age were 26.06 (±5.58) and 36.56 (±1.23), respectively. It was observed that nulliparous women had both higher perineal muscle strength (2.53 ± 0.57versus2.06 ± 0.64;P = 0.005) and higher electrical activity (45.35 ± 12.24 μV versus35.79 ± 11.66 μV;P = 0.003), while among the multiparous women, distensibility was higher (19.39 ± 1.92versus18.05 ± 2.14;P = 0.013). We observed that there was no correlation between perineal distensibility and electrical activity during maximal voluntary contraction (r = -0.193;P = 0.140). However, we found a positive relationship between vaginal palpation and surface electromyography (P = 0.008), but none between Epi-no values (P = 0.785).Conclusion.The electrical activity and muscle strength of the pelvic floor muscles of the multiparous women were damaged, in relation to the nulliparous women, while the perineal distensibility was lower in the latter group. There was a positive relationship between surface EMG and the modified Oxford scale.

Download Full-text

Assessment of the strength and electrical activity of the pelvic floor muscles of male‐to‐female transgender patients submitted to gender‐affirming surgery: A case series

Neurourology and Urodynamics ◽

10.1002/nau.24728 ◽

2021 ◽

Author(s):

Marina Hazin ◽

Caroline W. S. Ferreira ◽

Rogerson Andrade ◽

Eduarda Moretti ◽

Dayana R. Silva ◽

...

Keyword(s):

Pelvic Floor ◽

Electrical Activity ◽

Case Series ◽

Pelvic Floor Muscles ◽

Male To Female

Download Full-text

Simultaneous measurement of electrical activity of uterine, abdominal, and pelvic floor muscles during the second and third stages of labor

American Journal of Obstetrics & Gynecology MFM ◽

10.1016/j.ajogmf.2020.100171 ◽

2020 ◽

Vol 2 (4) ◽

pp. 100171

Author(s):

Kendra M. Gray ◽

Lauren Murphy ◽

Malini Chauhan ◽

Lelan McCann ◽

Richard Gerkin ◽

...

Keyword(s):

Pelvic Floor ◽

Electrical Activity ◽

Simultaneous Measurement ◽

Pelvic Floor Muscles

Download Full-text

Faculty Opinions recommendation of Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8136970.8536081 ◽

2011 ◽

Author(s):

Wilfrid Jänig

Keyword(s):

Pelvic Floor ◽

Neural Control ◽

Pelvic Floor Muscles

Download Full-text

Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

Interface Focus ◽

10.1098/rsfs.2019.0027 ◽

2019 ◽

Vol 9 (5) ◽

pp. 20190027 ◽

Cited By ~ 1

Author(s):

Dulce Oliveira ◽

Maria Vila Pouca ◽

João Ferreira ◽

Teresa Mascarenhas

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Levator Ani ◽

Symphysis Pubis ◽

Pelvic Floor Muscles ◽

Point Of View ◽

Normal Vaginal Delivery ◽

Tissue Integrity ◽

Levator Trauma ◽

Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

Download Full-text