Abstract
Objective
The study investigated the effect of a 6-week supervised pelvic floor muscle exercise
(PFME) program to prevent stress urinary incontinence (SUI) at 38 weeks’ gestation.
Study design
We conducted a randomized controlled trial into two arms design: one intervention
group and one control group, using the randomly computer-generated numbers. A research
assistant, who was not involved with care of the participants, randomly drawn up and
opened the envelope for each participant to allocate into the intervention group and
the control group. The investigators could not be blinded to allocation. Seventy primigravid
women who had continent with gestational ages of 20–30 weeks were randomly assigned
to participate in the intervention (n = 35) and control groups (n = 35). The intervention was a supervised 6-week PFME program with verbal instruction
and a handbook, three training sessions of 45 min with the main researcher (at 1st, 3rd and 5th week of the program) and self-daily
training at home for an overall period of 6 weeks. The control condition was the PFME
and the stop test had been trained by the main researcher to all of the participants
in the intervention group.
Outcomes
The primary outcome was self-reported of SUI, and the secondary outcome was the severity
of SUI in pregnant women which comprises of frequency, volume of urine leakage and
score of perceived severity of SUI in late pregnancy at 38th weeks of pregnancy. Statistical
analysis was performed using Chi-square test, Independent-sample t-test, and Mann–Whitney U-test. Significance P-value was <0.05.
Results
At the end of the intervention, 2 of 35 women in the intervention group and 5 of 35
women in the control group dropped out of the study. Therefore, the total of the study
participants consisted of 63 pregnant women (33 in the intervention group and 30 in
the control group). Fewer women in the intervention group reported SUI than the control
group: 9 of 33 (27.3%) versus 16 of 30 (53.3%) at 38 weeks’ gestational age (OR 3.05,
95% CI 1.07–8.70, P = 0.018).
Conclusions
The 6-week supervised PFME program was effective in preventing SUI and decreasing
the SUI severity in pregnant women who reported SUI at late pregnancy. The women who
performed PFME program under the training sessions once every two weeks found that
the program demands less time, incurs lower costs and possibly offers more motivation
to exercise. This 6-week supervised PFME program may be suitable in real clinical
situation.
Keywords
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References
- An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction.Int Urogynecol J. 2010; 21: 5-26
- The functional anatomy of the female pelvic floor and stress continence control system.Scand J Urol Nephrol Suppl. 2001; 207: 1-7
- Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work.Int Urogynecol J Pelvic Floor Dysfunct. 2004; 15: 76-84
- Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians.Eur J Obstet Gynecol Reprod Biol. 2010; 151: 14-19
- Urinary incontinence in women: management. Guideline 171.National Institute for Health and Clinical Excellence (NICE), 2013 ([accessed 30.10.15])
- Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.Cochrane Database Syst Rev. 2012; 10: CD007471
- Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review.Br J Sports Med. 2013; 48: 299-310
- Pelvic floor muscle training in the prevention and treatment of urinary incontinence in women – what is the evidence?.Acta Obstet Gynecol Scand. 2008; 87: 384-402
- The instruction in pelvic floor exercise provided to women during pregnancy or following delivery.Midwifery. 2001; 17: 55-64
- Can we prevent childbirth-related pelvic floor dysfunction.Br J Obstet Gynecol. 2013; 120: 137-140
- Effect of pelvic floor muscle exercise programme on stress urinary incontinence among pregnant women.J Adv Nurs. 2012; 68: 1997-2007
- Urinary incontinence: treatment, intervention, and outcome.Clin Nurse Spec. 1996; 10: 177-182
- A study of quality of life in primigravidae with urinary incontinence.Int Urogynecol J Pelvic Floor Dysfunct. 2004; 15: 160-164
- Conservative management of persistent post-natal urinary and faecal incontinence: randomised controlled trial.BMJ. 2001; 323: 593-596
- The Joanna Briggs Institute best practice information sheet: the effectiveness of pelvic floor muscle exercises on urinary incontinence in women following childbirth.Nurs Health Sci. 2011; 13: 378-381
- Effect of pelvic floor muscle exercises in the treatment of urinary incontinence during pregnancy and the postpartum period.Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20: 1223-1231
- Pelvic floor muscle exercise for the treatment of female stress urinary incontinence. III. Effect of two different degrees of pelvic floor muscle exercise.Neurourol Urodyn. 1990; 9: 489-502
- The effect of post-natal exercises to strengthen the pelvic floor muscles.Acta Obstet Gynecol Scand. 1996; 75: 382-385
- Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial.Obstet Gynecol. 2003; 101: 313-319
- Conservative management of urinary incontinence in women.Prim Care Update Ob Gyns. 2001; 8: 153-162
- Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomised controlled trial of antenatal pelvic floor exercise.Br J Obstet Gynecol. 2002; 109: 68-76
- Acceptability of a urinary continence promotion programme to women in postpartum.Br J Obstet Gynecol. 2003; 110: 188-196
- Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial.Int Urogynecol J. 2010; 21: 835-840
- Is home-based pelvic floor muscle training effective in treatment of urinary incontinence after birth in primiparous women? A randomized controlled trial.Acta Obstet Gynecol Scand. 2013; 92: 909-915
- Role of pelvic floor muscle exercises in the prevention of stress urinary incontinence during pregnancy and the postpartum period.Gynecol Obstet Invest. 2013; 75: 34-40
- A cross-sectional study of knowledge and practice of pelvic floor exercises during pregnancy and associated symptoms of stress urinary incontinence in North-East Scotland.Midwifery. 2007; 23: 204-217
- Is pelvic floor muscle training effective when taught in a general fitness class in pregnancy? A randomised controlled trial.Physiotherapy. 2011; 97: 190-195
- The diagnostic strength of the 24-h pad test for self-reported symptoms of urinary incontinence in pregnancy and after childbirth.Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 525-530
- Urinary incontinence in pregnancy and the puerperium: a prospective study.Am J Obstet Gynecol. 1999; 181: 266-273
Article info
Publication history
Published online: December 02, 2015
Accepted:
November 23,
2015
Received in revised form:
November 6,
2015
Received:
December 11,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
