scholarly journals Distensibility and Strength of the Pelvic Floor Muscles of Women in the Third Trimester of Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Carla Dellabarba Petricelli ◽  
Ana Paula Magalhães Resende ◽  
Julio Elito Júnior ◽  
Edward Araujo Júnior ◽  
Sandra Maria Alexandre ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Electrical Activity ◽  
Maternal Age ◽  
Surface Emg ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Third Trimester ◽  
The Third ◽  
Nulliparous Women ◽  
Multiparous Women

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.

scholarly journals Reliability of Pelvic Floor Muscle Assessment with Transabdominal Ultrasound in Young Nulliparous Women

2021 ◽  
Vol 10 (15) ◽  
pp. 3449
Author(s):  
Bartosz Zając ◽  
Iwona Sulowska-Daszyk ◽  
Anna Mika ◽  
Artur Stolarczyk ◽  
Ewelina Rosłoniec ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Ultrasound Image ◽  
Posterior Wall ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Quantitative Detection ◽  
Transabdominal Ultrasound ◽  
Nulliparous Women ◽  
The Right

The aim of this study was to assess the reliability of pelvic floor muscles evaluation via transabdominal ultrasonography in young nulliparous women and to present the methodology for quantitative assessment of the ultrasound image of the pelvic floor muscles visible as displacement of the posterior wall of the bladder, caused by action of the pelvic floor muscles. The study comprised 30 young, Caucasian, nulliparous women (age 22–27; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) without pelvic floor muscle dysfunctions. The intra-rater, test-retest and inter-rater reliability of pelvic floor muscles evaluation was performed using transabdominal ultrasound at rest and during voluntary contraction. The reliability was assessed at three points of the image (at the middle, on the right and left side). The reliability of the three-point measurement of the pelvic floor muscles transabdominal ultrasound is excellent in the case of intra-rater assessments, both at rest (ICC = 0.98–0.99) and during contraction (ICC = 0.97–0.98); moderate at rest (ICC = 0.54–0.62) and poor during contraction (ICC = 0.22–0.50) in the case of test–retest assessment; excellent at rest (ICC = 0.95–0.96), and good during contraction (ICC = 0.81–0.87) in the case of inter-rater assessment. Transabdominal ultrasound is a reliable method of pelvic floor muscle evaluation. The three-points of assessment used in our study allowed for broader and more comprehensive imaging of the pelvic floor muscle, e.g., for quantitative detection contractility imbalances between the left and right side Due to the fact that understanding mechanisms of pelvic floor muscle functioning is crucial in the therapy of pelvic floor dysfunctions, therefore, reliable, valid tests and instruments are important.

scholarly journals 443 Association between striae gravidarum and pelvic floor dysfunction symptoms during the third trimester of pregnancy

2021 ◽  
Vol 224 (2) ◽  
pp. S281
Author(s):  
Yael Lichtman ◽  
adi yehuda Weintraub ◽  
Reut Rotem ◽  
Maayan Elnir Katz ◽  
Tamar Matyashov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Third Trimester ◽  
The Third ◽  
Striae Gravidarum

Childbirth trauma

2020 ◽  
pp. 727-742
Author(s):  
Stergios Doumouchtsis
Keyword(s):  
Pelvic Floor ◽  
Anal Sphincter ◽  
Well Being ◽  
Anal Sphincter Injury ◽  
Nulliparous Women ◽  
Childbirth Trauma ◽  
Multiparous Women ◽  
Short And Long Term ◽  
Tissue Rupture ◽  
Nerve Muscle

Pelvic floor disorders are strongly associated with childbirth and are more prevalent in parous women. Pelvic floor trauma commonly occurs at the time of the first vaginal childbirth. Conventionally, childbirth trauma refers to perineal and vaginal trauma following delivery and the focus has been on the perineal body and the anal sphincter complex. However, childbirth trauma may involve different aspects of the pelvic floor. Pelvic floor trauma during vaginal childbirth may involve tissue rupture, compression, and stretching, resulting in nerve, muscle, and connective tissue damage. Some women may be more susceptible to pelvic floor trauma than others due to collagen weakness. Childbirth trauma affects millions of women worldwide. The incidence of perineal trauma is over 91% in nulliparous women and over 70% in multiparous women. A clinical diagnosis of obstetric anal sphincter injury (OASIS) is made in between 1% and 11% of women following vaginal delivery. Increased training and awareness around OASIS is associated with an increase in the reported incidence. Short- and long-term symptoms of childbirth trauma can have a significant effect on daily activities, psychological well-being, sexual function, and overall quality of life.

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

2020 ◽  
Vol 222 (1) ◽  
pp. S312-S313
Author(s):  
Kendra M. Gray ◽  
Roman Starikov ◽  
Malini Chauhan ◽  
Lelan Dao McCann ◽  
Robert Garfield
Keyword(s):  
Pelvic Floor ◽  
Electrical Activity ◽  
Pelvic Floor Muscles ◽  
Human Parturition

Functionality of the Pelvic Floor Muscles in Nulliparous Women According to the Level of Physical Activity [234]

2015 ◽  
Vol 125 ◽  
pp. 76S
Author(s):  
Fabiana O. Melo ◽  
Melania Maria Ramos Amorim ◽  
Lorena C. Macedo ◽  
Nicole V. Leal ◽  
Danilo A. Vasconcelos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles ◽  
Nulliparous Women

scholarly journals Perineal Distensibility Using Epi-no in Twin Pregnancies: Comparative Study with Singleton Pregnancies

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Juliana Sayuri Kubotani ◽  
Antonio Fernandes Moron ◽  
Edward Araujo Júnior ◽  
Miriam Raquel Diniz Zanetti ◽  
Vanessa Cardoso Marques Soares ◽  
...  
Keyword(s):  
Case Control Study ◽  
Abdominal Circumference ◽  
Third Trimester ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
The Third ◽  
Nulliparous Women ◽  
Twin Pregnancies ◽  
Control Study ◽  
Singleton Pregnancies

The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women’s perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit. It was then withdrawn while inflated and its circumference was measured. The unpaired Student’s t-test was used to compare perineal distensibility in the two groups and Pearson’s correlation coefficient (r) was used to correlate the pregnant women’s perineal distensibility with their anthropometric data. There was no difference in perineal distensibility between the twin group (16.51 ± 2.05 cm) and singleton group (16.13 ± 1.67 cm) (P=0.50). There was a positive correlation between perineal distensibility and abdominal circumference (r=0.36; P=0.01). The greater the abdominal circumference was, the greater the perineal distensibility was, regardless of whether the pregnancy was twin or singleton.

scholarly journals The Role of Gestational Diabetes Mellitus and Pelvic Floor 3D-Ultrasound Markers at the Second and Third Trimester of Pregnancy Predicting 6-18 Months Postpartum Urinary Incontinence: Preliminary Results From a Prospective Cohort

2021 ◽  
Author(s):  
Carlos Izaias Sartorão Filho ◽  
Fabiane Affonso Pinheiro ◽  
Luiz Takano ◽  
Raghavendra Hallur Lakshmana Shetty ◽  
Sthefanie K. Nunes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pelvic Floor ◽  
Univariate Analysis ◽  
3D Ultrasound ◽  
Third Trimester ◽  
The Third ◽  
Hiatal Area

Abstract Background Gestational Diabetes Mellitus and long-term urinary incontinence (UI) have a severe impact on women's health. New methods to identify pregnant predictor risk factors of UI are needed. Our study investigated clinical and pelvic floor 3D-ultrasound markers in pregnant women at the second and third trimesters to predict 6-18 months postpartum UI. Methods This ongoing prospective cohort study included one hundred five nulliparous pregnant women with universal GDM screening and diagnosis, treated with nutritional and healthy lifestyle intervention. Pelvic floor 3DUltrasound was performed at the second and third trimesters of gestation. Clinical and pelvic floor 3DUltrasound biometry were collected. The ICIQ-SF and ISI questionnaires for UI were applied in the third trimester and 6-18 months postpartum. We performed univariate analysis (P<.20) to extract risk factors variables and multivariate logistic regression analysis (P<.05) to obtain the adjusted relative ratio for 6-18 months postpartum UI. Results In a preliminary result, a total of 93 participants concluded the follow-up. Using the variables obtained by the univariate analysis and after the adjustments for potential confounders, logistic regression analysis revealed that Gestational Diabetes Mellitus exposure was a strong and independent risk factor for 6-18 months postpartum UI (Adjusted RR 8.088; 95%CI 1.17-55.87; P:.034). In addition, higher hiatal area distension at rest from the second to the third trimester was negatively correlated with 6-18 months postpartum UI (Adjusted RR 0.966; 95%CI 0.93-0.99; P: .023). Conclusion Gestational Diabetes Mellitus was positively correlated with 6-18 months postpartum UI, and a higher hiatal area distension was negatively correlated with 6-18 months postpartum UI development. Trial registration: Regulatory approval was obtained from the Institutional Review Board (number 1.716.895) by “Botucatu Medical School of São Paulo State University (Unesp)” Ethics Committee.

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