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Pelvic floor muscle strength in primiparous women according to type of delivery: a cross-sectional study

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Author(s):
Edilaine de Paula Batista Mendes
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD)
Defense date:
Examining board members:
Sonia Maria Junqueira Vasconcellos de Oliveira; Maria Luiza Gonzalez Riesco Bellini; Adriana de Souza Caroci
Advisor: Sonia Maria Junqueira Vasconcellos de Oliveira
Abstract

Introduction: Pregnancy, labor and delivery may influence the muscles of pelvic floor, which can cause transiently or permanently decreased of muscle strength, urinary incontinence and dyspareunia. Objective: 1. Identify the pelvic floor muscle strength (PFMS) in primiparous women after normal birth and cesarean section between 50 to 70 days postpartum; 2. Compare PFMS in primiparous women according to the type of delivery, sociodemographic, clinical and urogynecological woman characteristics, perineal exercise, birth data, perineal conditions and newborn clinical data. Methods: A Cross-sectional study conducted in the Municipal Maternity and Basic Health Units in the city of Itapecerica da Serra, Sao Paulo, Brazil. The sample consisted of 96 primiparous women, 24 after vaginal delivery and 72 after cesarean section, which met the inclusion criteria. The PFMS was evaluated by perineometry (PeritronTM 9301, Laborie). Descriptive analysis and analysis of variance with one and two factors were performed. The Research Ethics Committee of the University of São Paulo School of Nursing approved the research (CAAE: 13545113.5.0000.5392). Results: In total 169 women were recruited, of which 96 (56.8%) constituted the sample, and 73 (43.2%) were excluded because they did not return for the evaluation of PFMS two months after delivery. The average age was 21.7 (±4.8) years, most of women self-defining as mixed ethnicity (brown) (56.3%), have between 10 and 12 years of education (75%), living with a partner (78 1%) and not having a paid job (61.5%). The average PFMS in primiparous women was 24.0 cmH2O (±16.2) and 25.4 cmH2O (±14.7) after normal birth and caesarean section, respectively, with no significant difference (p=0.697). The sociodemographic variables presented no significant difference in PFMS, except for the years of study variable (p=0.036); from 12 years of study, normal birth women showed higher PFMS values compared to the cesarean women (42.0 ±26.3 cmH2O versus 14.6 ±7.7 cmH2O). For the clinical characteristics and urogynecological no difference was observed in PFMS according to type of delivery. The perineal exercise performed during pregnancy had an effect on PFMS in primiparous women after normal birth compared to those undergoing cesarean section (42.6 ±25.4 cmH2O versus 11.8 ±4.9 cmH2O; p=0.010). For the other variables (birth data, perineal conditions and newborn data) there were no significant differences in PFMS according to the type of delivery. Conclusion: There was no difference in PFMS of primiparous between women after normal birth and cesarean section. Primiparous women after normal birth, with 12 or more years of study had higher PFMS. Women who did perineal exercises in pregnancy had the highest PFMS after normal birth. (AU)

FAPESP's process: 13/01336-2 - PELVIC FLOOR MUSCLE STRENGTH IN PRIMIPAROUS WOMEN ACCORDDING TO TYPE OF DELIVERY: A CROSS-SECTIONAL STUDY
Grantee:Edilaine de Paula Batista Mendes
Support type: Scholarships in Brazil - Master