Zhao Yun, Xiao Mei, Tang Fei, Tang Wan, Yin Heng, Sun Guo-Qiang, Lin Yin, Zhou Yong, Luo Yan, Li Lu-Man, Tan Zhi-Hua
Department of Obstetrics Department of Pelvic Floor Rehabilitation, Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
Medicine (Baltimore). 2017 Oct;96(41):e8124. doi: 10.1097/MD.0000000000008124.
Water immersion delivery is a non-pharmacological approach to ease labor pain. This paper aims to investigate the effect of water immersion delivery on increasing strength of pelvic floor muscle (PFM) and relieving pelvic floor disorders (PFDs) during postpartum period.
A total of 2749 vaginal-delivery primiparas in postpartum 6-8 weeks were selected as research objects. Based on the modes of delivery, 600 patients were assigned into water immersion delivery group, 2149 were assigned into conventional delivery group. The scales of PFM strength and pelvic organ prolapsed (POP) were determined by specially trained personnel using digital palpation, and the symptoms of stress urinary incontinence (SUI) were investigated by questionnaire survey. The weak PFM strength was improved by doing Kegel exercise at home for 6-8 weeks.
We found that ①The rate of episiotomy in water immersion delivery group was 77.50% (465/600), which was lower than that in conventional delivery group (84.69%, 1820/2149) (P < .01); The primiparas without having an episiotomy have higher PFM strength than those having an episiotomy for both groups (P < .01). ②There was a negative correlation between the scale of PFM strength and SUI or POP, wherein the r-values were -0.135 and -0.435, respectively (P < .01). ③The rate of SUI was 6.50% (39/600) in water immersion delivery group and 6.89% (148/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05); ④The rates of vaginal wall prolapsed and uterus prolapsed were 29.83% (179/600) and 2.83% (17/600) in water immersion delivery group and 30.95% (665/2149) and 4.37% (94/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05). ⑤After Kegel exercise, the strength of PFM was promoted (P < .01).
Water immersion delivery has been proved to a beneficial alternative method for conventional delivery method. This delivery mode is associated with fewer episiotomy rate, and avoiding episiotomy is beneficial for maintaining PFM strength of women in postpartum 6-8 weeks. The strength of PFM during postpartum period can be improved by doing Kegel exercise at home.
水中分娩是一种缓解分娩疼痛的非药物方法。本文旨在探讨水中分娩对增加产后盆底肌肉（PFM）力量及缓解盆底功能障碍（PFDs）的效果。
选取2749例产后6 - 8周的经阴道分娩初产妇作为研究对象。根据分娩方式，将600例患者分为水中分娩组，2149例分为传统分娩组。由经过专门培训的人员通过数字触诊确定PFM力量和盆腔器官脱垂（POP）的量表，并通过问卷调查调查压力性尿失禁（SUI）症状。在家进行6 - 8周的凯格尔运动可改善PFM力量较弱的情况。
我们发现①水中分娩组的会阴切开率为77.50%（465/600），低于传统分娩组（84.69%，1820/2149）（P<0.01）；两组中未进行会阴切开的初产妇的PFM力量均高于进行会阴切开的初产妇（P<0.01）。②PFM力量量表与SUI或POP之间存在负相关，其中r值分别为 - 0.135和 - 0.435（P<0.01）。③水中分娩组的SUI发生率为6.50%（39/600），传统分娩组为6.89%（148/2
