OBJECTIVE: The purpose of this study was to determine if refraining from coached pushing during the second stage of labor affects postpartum urogynecologic measures of pelvic floor structure and function. STUDY DESIGN:Nulliparous women at term were randomized to coached (n = 67) vs uncoached (n = 61) pushing. At 3 months' postpartum women underwent urodynamic testing, pelvic organ prolapse examination (POPQ), and pelvic floor neuromuscular assessment. RESULTS: Urodynamic testing revealed decreased bladder capacity (427 mL vs 482 mL, P = .051) and decreased first urge to void (160 mL vs 202 mL, P = .025) in the coached group. Detrusor overactivity increased 2-fold in the coached group (16% vs 8%), although this difference was not statistically significant (P = .17). Urodynamic stress incontinence was diagnosed in the coached group in 11/67 (16%) vs 7/61 (12%) in the uncoached group (P = .42). CONCLUSION: Coached pushing in the second stage of labor significantly affected urodynamic indices, and was associated with a trend towards increased detrusor overactivity.
RCT Entities:
OBJECTIVE: The purpose of this study was to determine if refraining from coached pushing during the second stage of labor affects postpartum urogynecologic measures of pelvic floor structure and function. STUDY DESIGN: Nulliparous women at term were randomized to coached (n = 67) vs uncoached (n = 61) pushing. At 3 months' postpartum women underwent urodynamic testing, pelvic organ prolapse examination (POPQ), and pelvic floor neuromuscular assessment. RESULTS: Urodynamic testing revealed decreased bladder capacity (427 mL vs 482 mL, P = .051) and decreased first urge to void (160 mL vs 202 mL, P = .025) in the coached group. Detrusor overactivity increased 2-fold in the coached group (16% vs 8%), although this difference was not statistically significant (P = .17). Urodynamic stress incontinence was diagnosed in the coached group in 11/67 (16%) vs 7/61 (12%) in the uncoached group (P = .42). CONCLUSION: Coached pushing in the second stage of labor significantly affected urodynamic indices, and was associated with a trend towards increased detrusor overactivity.
Authors: Lawrence Leeman; Anne M Fullilove; Noelle Borders; Regina Manocchio; Leah L Albers; Rebecca G Rogers Journal: Birth Date: 2009-12 Impact factor: 3.689
Authors: Clifford Y Wai; Donald D McIntire; Shanna D Atnip; Joseph I Schaffer; Steven L Bloom; Kenneth J Leveno Journal: Int Urogynecol J Date: 2011-05-11 Impact factor: 2.894
Authors: Andrea Lemos; Melania Mr Amorim; Armele Dornelas de Andrade; Ariani I de Souza; José Eulálio Cabral Filho; Jailson B Correia Journal: Cochrane Database Syst Rev Date: 2017-03-26
Authors: Lisa Kane Low; Janis M Miller; Ying Guo; James A Ashton-Miller; John O L DeLancey; Carolyn M Sampselle Journal: Int Urogynecol J Date: 2012-07-25 Impact factor: 2.894