Pelvic PT Distance Journal Club March 2016
Background
·
Many studies have shown PFM exercise during
pregnancy can prevent and decrease UI
·
Study by Aran showed reduced PFM strength
associated with prolonged first stage of labor
·
That study also postulated a strong PFM might
limit decent or rotation of the fetal head
·
Other believe PFM exercises produce flexible,
well controlled muscles that can facilitate labor
Study
·
12 RCT (one quasi RCT) involving a total of
2,243 European and Chinese nulliparous women
·
excluded vaginal weights, electrical
stimulation, and biofeedback
·
Five outcomes evaluated
o Length
of first stage of labor
o Length
of second stage of labor
o Episiotomy
o Instrument
deliver - forceps or vacuum
o Perineal
laceration
·
Parameters of PFM training varied - 3 trials
ensured proper technique, see page 1421
Results
·
First stage of labor - PFM exercises
significantly decreased by 28.33 min on average (only Chinese studies measured
this)
·
Second stage of labor - PFM exercises
significantly decreased by 10.41 min on average
o Secondary
analysis was done is several ways
o Statically
sig only in Chinese studies
o No
difference for BMI, age or baby wt
·
Episiotomy - no sig diff
·
Instrument deliver - forceps or vacuum - no sig diff
·
Perineal laceration - no sig diff
Conclusion
·
Antenatal PFM training does not negatively
affect birth
·
Training may result in improved muscle control
and flexibility which may contribute to the descent or rotation of fetal head
·
Also may be related to a positive attitude
toward childbirth
Limitations
·
Several discussed including variety of training
schedules
·
Ethnicity differences also discussed
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