This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Marshall, K Articles by Baxter, G D Search for Related Content PubMed PubMed Citation Articles by Marshall, K Articles by Baxter, G D Social Bookmarking                   What's this?

The effect of a first vaginal delivery on the integrity of the pelvic ‘ oor musculature

D M Walsh

G D Baxter

Rehabilitation Sciences Research Group, University of Ulster at Jordanstown, Northern Ireland

Objective: To assess the specific effect of delivery of the first child on the integrity of the pelvic floor musculature.

Design: A prospective study of two groups of females with no symptoms of urinary incontinence.

Setting: Physiotherapy Department, Rotunda Lying In Hospital, Dublin.

Subjects: Two groups of healthy female physiotherapists (age range 20–28 years) were recruited for the study: group 1 consisted of nulliparous females (n = 10) and group 2 consisted of primiparous females who were 9–10 months post delivery (n = 10).

Intervention and main outcome measures: Assessment of the pelvic floor musculature was performed by digital assessment, electromyography and perineometry.

Results: For all data, the nulliparous group showed evidence of greater pelvic floor strength and endurance. Analysis of anterior and posterior electromyography data showed significantly stronger contractions in the nulliparous group (p = 0.0001 and 0.044). During a maximum contraction of the pelvic floor muscles, the anterior resting EMG activity increased by 9 ± 6 µV (mean ± SD) in the primiparous group compared with an increment of 22.3 ± 4.74 µV in the nulliparous group. Posterior EMG resting activity increased by 19.7 ± 7.65 µV (mean ± SD) in the nulliparous group compared with 13.8 ± 8.19 µV in the primiparous group. There were significant differences between the two groups for the four types of digital muscle assessment (p < 0.0013). In addition, there was a greater increase in perineometry readings in the nulliparous group (increment = 5.6 ± 2.5, mean ± SD) compared with the primiparous group (increment = 3.1 ± 0.9; mean ± SD).

Conclusions: This study suggests that irrespective of lack of symptoms of urinary incontinence, it would appear advisable that all women should undertake a prescribed programme of pelvic floor rehabilitation exercises after childbirth.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?