JOURNAL OF FEMALE
To test whether supervised pelvic floor exercises antenatally will reduce
the incidence of postpartum stress incontinence in at-risk primigravidae
with bladder neck mobility, ultrasonically proven.
Antenatal clinic in a UK NHS Trust Hospital.
Patients randomised to supervised pelvic floor exercises (n = 139)
attended a physiotherapist at monthly intervals from 20 weeks until
delivery. The exercises comprised three repetitions of eight contractions
each held for six seconds, with two minutes rest between repetitions.
These were repeated twice daily. At 34 weeks of gestation the number of
contractions per repetition was increased to 12. Both the untreated
control group and the study group received verbal advice on pelvic floor
exercises from their midwives antenatally.
is associated to the lesion of the pelvic floor with a potential to
developing stress urinary incontinence and prolapse. The possibility of
preventing these lesions by strengthening this musculature is encouraging.
In this random single blind trial, the patients that do supervised
exercises presented lesser rates of urinary incontinence than those that
received only verbal orientation (19.2%against 32.7%). In what refers to
the strengthening of the pelvic floor musculature these findings are
similar to those of other authors that showed that the supervision should
be fundamental for the correct realization of the exercises and the
adherence of the patient to the proposed treatment. It is curious to
observe that there was no significant difference in muscular strength
measured with a among
the groups that were studied. Only the patients with urinary incontinence
showed significantly diminished muscular strength. We must make clear that
the patients were pregnant for the first time, they were re-evaluated
after three months of birth and the incontinence was classified as light
in all the patients that presented urinary loss. In many cases a
regression occurs regression of the complaints with a few additional
months of follow-up, but these patients form a risk group for the
development of SUI in long term.
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