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Continence and pelvic floor status in nulliparous women at midterm pregnancy

International Urogynecology Journal volume 23, pages 1257–1263 (2012)Cite this article

Abstract

Introduction and hypothesis

A Cochrane review recommends antenatal pelvic floor muscle training (PFMT) in urinary incontinence (UI) prevention. The aim of the study was to investigate nulliparous pregnant women’s knowledge about and practising of PFMT, their pelvic floor muscle (PFM) function, and ability to contract correctly. It was hypothesized that continent women had higher PFM strength and endurance than women with UI.

Methods

Three hundred nulliparous women at gestational week 18–22 were included in a cross-sectional study. Vaginal resting pressure, maximum voluntary contraction, and PFM endurance were measured by manometer. UI was assessed by International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF). Comparisons of PFM function in continent women and women with UI were analyzed using independent-samples t test. Mean differences with 95 % confidence interval (CI) are presented.

Results

Of 300 women, 89 % had heard of PFMT at mid pregnancy, and 35 % performed PFMT once or more a week. After thorough instruction 4 % were unable to contract correctly. Thirty-five percent reported UI, of whom 48 % performed PFMT once or more a week. Continent women had significantly higher PFM strength and endurance when compared with women having UI, with mean differences of 6.6 cmH2O (CI 2.3–10.8, p = 0.003), and 41.5 cmH2Osec (CI 9.8–73.1, p = 0.010), respectively. No difference was found for vaginal resting pressure (p = 0.054).

Conclusions

Most nulliparous pregnant women knew about PFMT. Thirty-five percent performed PFMT once or more a week. Incontinent nulliparous pregnant women had weaker PFM than their continent counterparts. More emphasis on information regarding PFM function and PFMT is warranted during pregnancy.

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Acknowledgements

We gratefully acknowledge the South-Eastern Norway Regional Health Authority and the Norwegian Research Council for funding this research.

Conflicts of interest

None.

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Affiliations

  1. Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål stadion, 0806, Oslo, Norway

    Gunvor Hilde & Kari Bø

  2. Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway

    Gunvor Hilde, Jette Stær-Jensen, Marie Ellström Engh, Ingeborg Hoff Brækken & Kari Bø

  3. Faculty Division Akershus University Hospital, University of Oslo, Oslo, Norway

    Marie Ellström Engh

Authors
  1. Gunvor Hilde
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  2. Jette Stær-Jensen
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  3. Marie Ellström Engh
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  4. Ingeborg Hoff Brækken
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  5. Kari Bø
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Correspondence to Gunvor Hilde.

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Hilde, G., Stær-Jensen, J., Ellström Engh, M. et al. Continence and pelvic floor status in nulliparous women at midterm pregnancy. Int Urogynecol J 23, 1257–1263 (2012). https://doi.org/10.1007/s00192-012-1716-0

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  • DOI: https://doi.org/10.1007/s00192-012-1716-0

Keywords

  • Exercise
  • Urinary incontinence / prevention and control
  • Pelvic floor
  • Pregnancy
  • Prenatal care
  • Strength training