Does pelvic floor muscle training prevent and treat urinary and fecal incontinence in pregnancy?

This Practice Point commentary discusses the systematic review by Hay-Smith and colleagues, which investigated the efficacy of pelvic floor muscle training (PFMT) for preventing and treating urinary and fecal incontinence in pregnant and postnatal women. The authors concluded that antenatal PFMT improved continence outcomes during first pregnancy, and that PFMT represents an appropriate treatment for women with persistent postpartum incontinence. This systematic review is of high methodological quality. Nevertheless, the exclusion of studies with nonrandomized designs and the inclusion of large studies of weak interventions might have resulted in an underestimation of the effect of PFMT. The dose-response relationship is important in PFMT, and intensive training with close follow-up is required to achieve beneficial effects.