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Transabdominal ultrasound to assess the displacement of the bladder base during abdominal and pelvic floor contractions in continent parous versus nulliparous women

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Abstract

Introduction and hypothesis

The effect of different abdominal contractions on the position of pelvic organs in parous women during postpartum exercises has not been sufficiently assessed. The aim of this study was to evaluate the displacement of the bladder base (BB) during different pelvic floor and abdominal contractions in parous women compared to nulliparous women. We hypothesised that abdominal and perineal contractions will produce a disparate effect on the position of the BB between groups.

Methods

Cross-sectional study including a convenience sample of 63 volunteers (35 nulliparous vs. 28 postpartum women). Transabdominal ultrasound was used in mode B to image the displacement of the BB. The protocol included six different pelvic floor and abdominal contractions commonly used in postpartum rehabilitation.

Results

The BB elevated significantly more in the postpartum group compared to nulliparous women when performing submaximal contraction of pelvic floor and transversus abdominis muscles simultaneously with axial elongation of the back (0.93 ± 0.55 cm in parous women vs. 0.66 ± 0.46 cm in nulliparous women). In contrast, the BB was found to descend significantly during a curl-up contraction in both groups (0.93 ± 0.55 cm in parous women vs. 0.66 ± 0.46 cm in nulliparous women).

Conclusions

The overall results of this study showed that perineal and superficial abdominal contractions produced different immediate effects compared to deep abdominal contractions on the displacement of BB in parous and nulliparous women. Further research is required to assess the long-term effects of these contractions.

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Abbreviations

BB:

Bladder base

ICC:

Intraclass correlation coefficient

OI:

Obliquus internus muscle

OE:

Obliquus externus muscle

PFM:

Pelvic floor muscles

RA:

Rectus abdominis muscle

TrA:

Transversus abdominis muscle

US:

Ultrasound

TransvTAUS:

Transverse transabdominal ultrasound

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Acknowledgments

The authors acknowledge PRIM S.A. (Spain) for their support by providing the US logiq-E equipment and PHENIX®, VIVALTIS (France) for providing the PHENIX USB NEO Biofeedback apparatus for the data collection of this research.

The authors also acknowledge the midwives from San José Health Center, Galician Healthcare Service (A Coruña, Spain), for their contribution to recruiting subjects and providing the clinical setting during the data collection.

Funding

The authors thank COFIGA (Colegio Oficial de Fisioterapeutas de Galicia) for funding this research (Research Grant 2018–2019 modality B).

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Correspondence to Asunción Ferri-Morales.

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Martínez-Bustelo, S., Ferri-Morales, A., Corral-Gómez, L. et al. Transabdominal ultrasound to assess the displacement of the bladder base during abdominal and pelvic floor contractions in continent parous versus nulliparous women. Int Urogynecol J 33, 2257–2266 (2022). https://doi.org/10.1007/s00192-021-04756-4

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