Marcos Massaru Okido1, Fabiana Lellis Valeri1, Wellington Paula Martins1,2,3, Cristine Homsi Jorge Ferreira4, Geraldo Duarte1, Ricardo Carvalho Cavalli5. 1. Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil. 2. School of Ultrasonography and Medical Recycling of Ribeirão Preto (EURP), Ribeirão Preto, Brazil. 3. National Institute of Science and Technology (INCT) of Hormones and Women's Health, Ribeirão Preto, Brazil. 4. Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil. 5. Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil. rcavalli@fmr.usp.br.
Abstract
INTRODUCTION AND HYPOTHESIS: The objective was to assess foetal wellbeing in pregnant women subjected topelvic floor muscle training (PFMT) by evaluating the acute and chronic effects of the procedure using the Doppler method. METHODS:Ninety-six primigravidae with singleton pregnancies and at a low risk of pregnancy complications were randomised to either intervention with PFMT or no intervention. The final analysis included 26 women in the intervention group and 33 in the control group. Women from the intervention group were subjected to a daily PFMT program. Evidence of possible foetal risk was assessed by Doppler and the control group received standard care. The protocol was conducted from 20 to 36 weeks' gestation. The pulsatility indices (PI) of the uterine, umbilical and middle cerebral arteries were determined at 28, 32 and 36 weeks' gestation. The acute effects were determined by comparing the values obtained before and after exercise in the group subjected to PFMT and the chronic effects were determined by comparing the resting values of the trained group with those of the control group. RESULTS: The results obtained showed normal values for the three gestational ages in both groups, with no difference between groups. Comparison before and after exercise showed a significant decline in the PI of uterine artery at 36 weeks without changes in the flow of umbilical and middle cerebral arteries. CONCLUSION:Pelvic floor muscle training in low-risk primigravidae with singleton pregnancies was associated with a significant decline in PI of the uterine artery after exercise, while no significant changes in the flow of the middle cerebral and umbilical arteries were found. The PFMT may be recommended to women as a first-line measure to prevent of urinary incontinence during pregnancy.
RCT Entities:
INTRODUCTION AND HYPOTHESIS: The objective was to assess foetal wellbeing in pregnant women subjected to pelvic floor muscle training (PFMT) by evaluating the acute and chronic effects of the procedure using the Doppler method. METHODS: Ninety-six primigravidae with singleton pregnancies and at a low risk of pregnancy complications were randomised to either intervention with PFMT or no intervention. The final analysis included 26 women in the intervention group and 33 in the control group. Women from the intervention group were subjected to a daily PFMT program. Evidence of possible foetal risk was assessed by Doppler and the control group received standard care. The protocol was conducted from 20 to 36 weeks' gestation. The pulsatility indices (PI) of the uterine, umbilical and middle cerebral arteries were determined at 28, 32 and 36 weeks' gestation. The acute effects were determined by comparing the values obtained before and after exercise in the group subjected to PFMT and the chronic effects were determined by comparing the resting values of the trained group with those of the control group. RESULTS: The results obtained showed normal values for the three gestational ages in both groups, with no difference between groups. Comparison before and after exercise showed a significant decline in the PI of uterine artery at 36 weeks without changes in the flow of umbilical and middle cerebral arteries. CONCLUSION: Pelvic floor muscle training in low-risk primigravidae with singleton pregnancies was associated with a significant decline in PI of the uterine artery after exercise, while no significant changes in the flow of the middle cerebral and umbilical arteries were found. The PFMT may be recommended to women as a first-line measure to prevent of urinary incontinence during pregnancy.
Entities:
Keywords:
Diaphragm of the pelvis; Exercise; Foetal suffering; Pregnancy; Urinary incontinence
Authors: Cristine H Ferreira; Luciane M V Naldoni; Juliana Dos Santos Ribeiro; Maria Cristina C C Meirelles; Ricardo de Carvalho Cavalli; Kari Bø Journal: Acta Obstet Gynecol Scand Date: 2014-04-30 Impact factor: 3.636
Authors: Andrea Lemos; Ariani Impieri de Souza; Ana Laura Carneiro Gomes Ferreira; José Natal Figueiroa; José Eulálio Cabral-Filho Journal: Int J Urol Date: 2008-08-20 Impact factor: 3.369
Authors: Stephanie J Woodley; Peter Lawrenson; Rhianon Boyle; June D Cody; Siv Mørkved; Ashleigh Kernohan; E Jean C Hay-Smith Journal: Cochrane Database Syst Rev Date: 2020-05-06