Aran Turhan, Pekgöz Ipek, Bozkaya Hasan, Osmanagaoglu Mehmet A
a Department of Obstetrics and Gynecology, School of Medicine , Karadeniz Technical University , Trabzon , Turkey.
J Obstet Gynaecol. 2018 Nov;38(8):1060-1064. doi: 10.1080/01443615.2018.1446922. Epub 2018 Mar 23.
We hypothesised that the pressure on the cervix increases with advancing gestation and it may lead to a cervical shortening and cause preterm labour in women with weak pelvic floor muscles. The aim of this prospective study was to measure vaginal resting pressure and pelvic floor muscle strength in the first trimester of pregnancy and to investigate their effects on labour. A study was conducted on the pregnant women with a low risk for preterm birth. The pelvic floor muscle strength and vaginal resting pressure were assessed in 320 pregnant women at their first trimester with a vaginal pressure measurement device. Fifty-two pregnant women were hospitalised for tocolytic therapy because of spontaneous preterm labour. Thirty-two of them (10.2%) had a preterm delivery despite the tocolytic therapy. Both the vaginal resting pressure (p = .009, 95%CI: 0.8; 5.9) and the pelvic floor muscle strength (p = .01, 95%CI: 3.5; 13.1) were significantly lower in the women with a preterm labour. Impact statement What is already known on this subject? The pelvic floor muscles have an essential role in continence and provide support to the pelvic organs. They also have an impact on labour. The pelvic floor muscles should distend to allow the passage of the foetus during labour. The rotation and flexion of the foetal head is due to the pelvic floor resistance. The effect of a vaginal birth on the pelvic floor's function is readily understood. On the other hand, the effect of the pelvic floor muscle function on labour is still controversial. What do the results of this study add? This prospective study showed that there is a negative association between the pelvic floor muscle strength and preterm labour. This is the first clinical study indicating that weak pelvic floor muscles may cause a preterm labour. What are the implications of these findings for clinical practice and/or further research? Pelvic floor physical therapy may be an alternative preventive strategy to reduce the risk of a spontaneous preterm birth.
我们假设，随着孕周增加，宫颈压力会升高，这可能导致宫颈缩短，并致使盆底肌肉薄弱的女性发生早产。这项前瞻性研究的目的是测量妊娠早期的阴道静息压力和盆底肌肉力量，并研究它们对分娩的影响。对早产风险较低的孕妇进行了一项研究。使用阴道压力测量装置对320名妊娠早期孕妇的盆底肌肉力量和阴道静息压力进行了评估。52名孕妇因自发性早产住院接受宫缩抑制剂治疗。其中32名（10.2%）孕妇尽管接受了宫缩抑制剂治疗仍发生了早产。早产孕妇的阴道静息压力（p = 0.009，95%CI：0.8；5.9）和盆底肌肉力量（p = 0.01，95%CI：3.5；13.1）均显著较低。影响声明关于该主题已知的信息有哪些？盆底肌肉在控尿方面发挥着重要作用，并为盆腔器官提供支撑。它们也对分娩有影响。分娩时盆底肌肉应扩张以允许胎儿通过。胎儿头部的旋转和屈曲归因于盆底阻力。阴道分娩对盆底功能的影响很容易理解。另一方面，盆底肌肉功能对分娩的影响仍存在争议。这项研究的结果有何新发现？这项前瞻性研究表明，盆底肌肉力量与早产之间存在负相关。这是第一项表明盆底肌肉薄弱可能导致早产的临床研究。这些发现对临床实践和/或进一步研究有何启示？盆底物理治疗可能是降低自发性早产风险的一种替代预防策略。
