Manzotti Andrea, Fumagalli Simona, Zanini Sonia, Brembilla Veronica, Alberti Adele, Magli Ilaria, Buratti Elis, Coraglia Nicoletta, De Fusco Andrea, Zambù Daniel, Zanotta Valeria, Nespoli Antonella
RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy.
Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy.
Eur J Midwifery. 2024 Aug 2;8. doi: 10.18332/ejm/189955. eCollection 2024.
This scoping review aims to comprehensively explore the existing research on the changes in pelvic floor function that occur throughout the childbirth pathway (antenatal, intrapartum, and postnatal period). Furthermore, it seeks to identify new opportunities and directions for future research in this field. In particular, this review focuses on investigating pelvic floor muscle strength and tone in women during the childbirth pathway.
The following databases were investigated from their inception: PubMed, OVID, Medline, ScienceDirect, The Cochrane Central Library, Scopus, Web of Science, PEDro, Scholar Google, Embase, and CINHAIL. Literature research was carried out from March to October 2022. Records identified through database searching were imported to Covidence. According to Arksey and O'Malley's five-stage scoping review framework, researchers screen titles and abstracts for eligibility and exclude records that do not meet the inclusion criteria.
A total of 40 studies were included in the data extraction phase. These articles underwent a review, with a specific emphasis on examining the tone, strength, and distensibility of the pelvic floor throughout the childbirth pathway. Among the selected studies, 22 investigated pelvic floor strength, 7 the distensibility, and 3 articles the tone.
This review identified both areas of agreement and disagreement across all three themes examined, with a particular emphasis on labor and the postpartum period. Notably, the review unveiled a significant scarcity of data concerning the tone of pelvic floor muscles throughout the childbirth pathway. Further studies to investigate the relationship between midwifery care and pelvic floor outcomes are required to improve clinical practice.
本范围综述旨在全面探索有关分娩过程（产前、产时和产后阶段）中盆底功能变化的现有研究。此外，它还试图确定该领域未来研究的新机会和方向。特别是，本综述着重调查分娩过程中女性的盆底肌肉力量和张力。
对以下数据库自创建以来的数据进行了调查：PubMed、OVID、Medline、ScienceDirect、Cochrane 中央图书馆、Scopus、科学网、PEDro、谷歌学术、Embase 和 CINHAIL。于2022年3月至10月进行文献研究。通过数据库搜索识别出的记录被导入到Covidence中。根据阿克斯和奥马利的五阶段范围综述框架，研究人员筛选标题和摘要以确定其是否符合纳入标准，并排除不符合标准的记录。
数据提取阶段共纳入40项研究。对这些文章进行了综述，特别着重于检查分娩过程中盆底的张力、力量和伸展性。在所选研究中，22项研究调查了盆底力量，7项研究了伸展性，3篇文章研究了张力。
本综述确定了在所研究的所有三个主题上存在共识和分歧的领域，尤其着重于分娩期和产后阶段。值得注意的是，该综述揭示了在整个分娩过程中关于盆底肌肉张力的数据严重匮乏。需要进一步开展研究以调查助产护理与盆底结局之间的关系，从而改善临床实践。
