Whitford Heather M, Alder Beth, Jones Martyn
University of Dundee, School of Nursing and Midwifery, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Midwifery. 2007 Sep;23(3):298-308. doi: 10.1016/j.midw.2006.05.009. Epub 2006 Oct 17.
to establish the reported practice of pelvic floor exercises and stress urinary incontinence after delivery.
a longitudinal study using a postnatal postal questionnaire.
257 women in the North-East of Scotland were sent questionnaires between June and December 2000, 6-12 months after delivery (previously recruited and interviewed during the last trimester of pregnancy). One hundred and sixty-three women responded (63.4%).
more women reported the practice of pelvic floor exercises after delivery than during pregnancy: 134 (83.2%) compared with 123 (76.4%). Six to 12 months after delivery, 96 (60%) women said that they were still doing the exercises. A third of respondents (n=54, 33.1%) reported stress incontinence at some time since having the baby. Of those reporting incontinence at the time of questionnaire completion, six (19.3%) said the incontinence was moderate or severe, whereas eight (34.7%) reported incontinence once a week or more. Women who had an operative vaginal delivery (forceps or ventouse delivery) were more likely to report the practice of pelvic floor exercises than those having a spontaneous vaginal delivery. No significant difference was found in reported rates of stress incontinence between women who had different modes of delivery. The practice of pelvic floor exercises daily or more often during pregnancy was associated with less reported postnatal incontinence compared with less frequent practice.
self-reported rates of practice of pelvic floor exercises increased from pregnancy to the immediate postnatal period and subsequently declined. A third of women reported the symptoms of stress incontinence after delivery. Daily or more frequent practice of the exercises during pregnancy may be required in order to prevent postnatal incontinence (although further research is required to confirm this finding).
midwives should continue to encourage regular and frequent practice of pelvic floor exercises in the postnatal period and beyond. They also need to ask about symptoms of stress incontinence and refer as necessary.
确立产后盆底肌锻炼及压力性尿失禁的报告做法。
采用产后邮寄问卷调查的纵向研究。
2000年6月至12月，在分娩后6 - 12个月（此前在妊娠晚期招募并接受访谈），向苏格兰东北部的257名女性发送了问卷。163名女性做出回应（63.4%）。
与孕期相比，更多女性报告在产后进行盆底肌锻炼：134名（83.2%）与123名（76.4%）。分娩后6至12个月，96名（60%）女性表示仍在进行锻炼。三分之一的受访者（n = 54，33.1%）报告自生育后曾出现压力性尿失禁。在完成问卷调查时报告有尿失禁的女性中，6名（19.3%）表示尿失禁为中度或重度，而8名（34.7%）报告每周尿失禁一次或更多次。接受阴道助产（产钳或胎头吸引助产）的女性比自然阴道分娩的女性更有可能报告进行盆底肌锻炼。不同分娩方式的女性报告的压力性尿失禁发生率无显著差异。与锻炼频率较低相比，孕期每天或更频繁地进行盆底肌锻炼与产后报告的尿失禁较少相关。
自我报告的盆底肌锻炼实施率从孕期到产后即刻有所增加，随后下降。三分之一的女性报告产后出现压力性尿失禁症状。为预防产后尿失禁，孕期可能需要每天或更频繁地进行锻炼（尽管需要进一步研究来证实这一发现）。
助产士应继续鼓励在产后及之后定期且频繁地进行盆底肌锻炼。他们还需要询问压力性尿失禁症状并在必要时进行转诊。
