Document Detail

The effect of a first vaginal delivery on the integrity of the pelvic floor musculature.
MedLine Citation:
PMID:  12428829     Owner:  NLM     Status:  MEDLINE    
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 microV (mean +/- SD) in the primiparous group compared with an increment of 22.3 +/- 4.74 microV in the nulliparous group. Posterior EMG resting activity increased by 19.7 +/- 7.65 microV (mean +/- SD) in the nulliparous group compared with 13.8 +/- 8.19 microV 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.
K Marshall; D M Walsh; G D Baxter
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical rehabilitation     Volume:  16     ISSN:  0269-2155     ISO Abbreviation:  Clin Rehabil     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-13     Completed Date:  2003-03-04     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  8802181     Medline TA:  Clin Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  795-9     Citation Subset:  IM    
Rehabilitation Sciences Research Group, University of Ulster at Jordanstown, Northern Ireland.
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MeSH Terms
Analysis of Variance
Data Interpretation, Statistical
Delivery, Obstetric / adverse effects*
Muscle Contraction / physiology*
Muscle Fatigue / physiology*
Parity / physiology*
Pelvic Floor / physiology*
Perineum / physiology
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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