Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Int Urogynecol J. 2021 Jul;32(7):1875-1882. doi: 10.1007/s00192-021-04846-3. Epub 2021 Jun 5.
Reduced pelvic floor muscle (PFM) strength and thickness are considered critical factors in pregnancy-related stress urinary incontinence. Various methods have been evaluated for the measurement of these two factors, but validity needs to be well established. The objective was to assess the strength and thickness of pelvic floor muscles of continent and incontinent primigravida women using the digital method and transperineal ultrasound, and to study the correlation between the two methods.
Assessment of pelvic floor muscle strength and thickness using digital assessment and transperineal ultrasound antepartum and postpartum in 100 primigravida women.
A total of 100 primigravida women with 46 in the study group (incontinent) and 54 in the control group (continent) were assessed. PFM strength was lower in incontinent women, with a score of 3 or less in 82.61% (38 out of 46) compared with a score of 4 or more in 98.15% of continent women (53 out of 54; p < 0.0001) antenatally, as well as postnatally, with 81.25% of the incontinent women (26 out of 32), with a score of 3 or less compared with 100% of continent women (24 out of 24), with a score of 4 or more (p < 0.0001). The PFM thickness in the incontinent group compared with the continent group at relaxation was 5.94 ± 0.51 mm and 6.64 ± 0.26 mm (p < 0.0001) antenatally and 5.98 ± 0.55 mm and 6.69 ± 0.23 mm (p < 0.0001) postnatally; at contraction it was 7.29 ± 0.56 mm and 8.70 ± 0.24 mm (p < 0.0001) antenatally and 7.39 ± 0.56 mm and 8.77 ± 0.20 mm (p < 0.0001) postnatally. The Pearson correlation coefficient for the two methods during the antenatal and postpartum periods was 0.864 and 0.743 respectively, suggestive of a positive correlation between the two methods.
Pelvic floor muscle strength, as well as thickness, is significantly lower among the incontinent group than among the continent group, both during antenatal and during the postnatal period.
盆底肌（PFM）力量和厚度的减弱被认为是妊娠相关压力性尿失禁的关键因素。已经评估了各种方法来测量这两个因素，但需要很好地建立有效性。目的是使用数字方法和经会阴超声评估有和无妊娠相关压力性尿失禁的初产妇的盆底肌肉力量和厚度，并研究两种方法之间的相关性。
对 100 名初产妇进行了数字评估和经会阴超声评估，评估内容包括产前和产后的盆底肌肉力量和厚度。
共有 100 名初产妇，其中 46 名在研究组（失禁），54 名在对照组（无失禁）。失禁组的 PFM 力量较低，产前 82.61%（38 名）的评分低于 3 分，而无失禁组 98.15%（53 名）的评分高于 4 分（p<0.0001），产后 81.25%（26 名）的评分低于 3 分，而无失禁组 100%（24 名）的评分高于 4 分（p<0.0001）。与无失禁组相比，失禁组在放松时的 PFM 厚度为 5.94±0.51mm 和 6.64±0.26mm（p<0.0001），产前；5.98±0.55mm 和 6.69±0.23mm（p<0.0001），产后；收缩时为 7.29±0.56mm 和 8.70±0.24mm（p<0.0001），产前；7.39±0.56mm 和 8.77±0.20mm（p<0.0001），产后。产前和产后两种方法的 Pearson 相关系数分别为 0.864 和 0.743，提示两种方法之间存在正相关。
在产前和产后期间，失禁组的盆底肌力量和厚度均明显低于无失禁组。
