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Sunday, March 13, 2016

Assessment of foetal wellbeing in pregnant women subjected to pelvic floor muscle training: a controlled randomized study. Okido MM, et al. Int Urogynecol J (2015) 26:1475-1481.

Beth Shelly
Pelvic PT Distance Journal Club March 9, 2016

Background

·         UI prevalence increases 11 times during pregnancy

·         32-64% of pregnant women have UI

·         PFMT during pregnancy reduces UI at the end of pregnancy and up to 3 months after delivery

·         Moderate intensity general exercise (walking, cycling) does not cause fetal effect on blood supply

·         However, PFM and uterus share vascular supply

Study

·         Healthy pregnancies

·         26 women in intervention group, 33 controls

·         Intervention group

o   Daily PFM exercises - 16 weeks

o   6 to 8 second hold, 10 reps, four positions (left side lying, sitting, quadruped, standing)

o   Adherence diary

o   Weekly PT sessions

·         Ultrasound measure of blood flow (pulse indices) - unblinded

o   Uterine artery - common iliac artery to uterus

o   Umbilical artery - placenta to baby

o   Middle cerebral artery - fetal brain

Results

·         No significant changes in umbilical artery and middle cerebral artery from intervention to control or before and after exercise

·         significant decrease in uterine artery blood flow at 36 weeks after exercise

Limitations - see paper

Discussion

·         Other studies have shown no changes in umbilical artery flow even with changes in uterine blood flow

·         Need studies on women with pregnancy complications

Conclusion - PFM exercises do not affect the fetus and should be recommended in healthy pregnancies.

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