Bø Kari, Hilde Gunvor, Jensen Jette Stær, Siafarikas Franziska, Engh Marie Ellstrøm
Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål stadion, 0806, Oslo, Norway,
Int Urogynecol J. 2013 Dec;24(12):2065-70. doi: 10.1007/s00192-013-2133-8. Epub 2013 Jun 8.
Theoretically, tight or strong pelvic floor muscles may impair the progress of labor and lead to instrumental deliveries. We aimed to investigate whether vaginal resting pressure, pelvic floor muscle strength, or endurance at midpregnancy affect delivery outcome.
This was a prospective cohort study of women giving birth at a university hospital. Vaginal resting pressure, pelvic floor muscle strength, and endurance in 300 nulliparous pregnant women were assessed at mean gestational week 20.8 (±1.4) using a high precision pressure transducer connected to a vaginal balloon. Delivery outcome measures [acute cesarean section, prolonged second stage of labor (> 2 h), instrumental vaginal delivery (vacuum and forceps), episiotomy, and third- and fourth-degree perineal tear) were retrieved from the hospital's electronic birth records.
Twenty-three women were lost to follow-up, mostly because they gave birth at another hospital. Women with prolonged second stage had significantly higher resting pressure than women with second stage less than 2 h; the mean difference was 4.4 cmH2O [95 %confidence interval (CI) 1.2-7.6], p < 0.01, adjusted odds ratio 1.049 (95 % CI 1.011-1.089, p = 0.012). Vaginal resting pressure did not affect other delivery outcomes. Pelvic floor muscle strength and endurance similarly were not associated with any delivery outcomes.
While midpregnancy vaginal resting pressure is associated with prolonged second stage of labor, neither vaginal resting pressure nor pelvic floor muscle strength or endurance are associated with operative delivery or perineal tears. Strong pelvic floor muscles are not disadvantageous for vaginal delivery.
从理论上讲，盆底肌肉过紧或过强可能会妨碍分娩进程并导致器械助产。我们旨在研究孕中期的阴道静息压力、盆底肌肉力量或耐力是否会影响分娩结局。
这是一项针对在大学医院分娩的女性的前瞻性队列研究。使用连接阴道球囊的高精度压力传感器，在平均妊娠周数20.8（±1.4）时评估了300名未生育孕妇的阴道静息压力、盆底肌肉力量和耐力。从医院的电子分娩记录中获取分娩结局指标[急诊剖宫产、第二产程延长（>2小时）、器械阴道分娩（真空吸引和产钳）、会阴切开术以及三度和四度会阴撕裂]。
23名女性失访，主要原因是她们在另一家医院分娩。第二产程延长的女性的静息压力显著高于第二产程少于2小时的女性；平均差异为4.4厘米水柱[95%置信区间（CI）1.2 - 7.6]，p<0.01，调整后的优势比为1.049（95%CI 1.011 - 1.089，p = 0.012）。阴道静息压力不影响其他分娩结局。盆底肌肉力量和耐力同样与任何分娩结局均无关联。
虽然孕中期阴道静息压力与第二产程延长有关，但阴道静息压力、盆底肌肉力量或耐力均与手术分娩或会阴撕裂无关。盆底肌肉强壮对阴道分娩并无不利影响。
