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Clinical Trial
. 2002 May 25;324(7348):1241.
doi: 10.1136/bmj.324.7348.1241.

Promoting urinary continence in women after delivery: randomised controlled trial

Pauline Chiarelli  1 , Jill Cockburn
Affiliations
Clinical Trial

Promoting urinary continence in women after delivery: randomised controlled trial

Pauline Chiarelli et al. BMJ. .

Abstract

Objectives: To test the effectiveness of a physiotherapist delivered intervention designed to prevent urinary incontinence among women three months after giving birth.

Design: Prospective randomised controlled trial with women randomised to receive the intervention (which entailed training in pelvic floor exercises and incorporated strategies to improve adherence) or usual postpartum care.

Setting: Postpartum wards of three tertiary teaching hospitals in the Hunter region, New South Wales, Australia.

Participants: Women who had forceps or ventouse deliveries or whose babies had a high birth weight (> or =4000 g), or both-676 (348 in the intervention group and 328 in the usual care group) provided endpoint data at three months.

Main outcome measures: Urinary incontinence at three months measured as a dichotomous variable. The severity of incontinence was also measured. Self report of the frequency of performance of pelvic floor exercises was recorded.

Results: At three months after delivery, the prevalence of incontinence in the intervention group was 31.0% (108 women) and in the usual care group 38.4% (125 women); difference 7.4% (95% confidence interval 0.2% to 14.6%, P=0.044). At follow up significantly fewer women with incontinence were classified as severe in the intervention group (10.1%) v (17.0%), difference 7.0%, 1.6% to 11.8%). The proportions of women reporting doing pelvic floor exercises at adequate levels was 84% (80% to 88%) for the intervention group and 58% (52% to 63%) for the usual care group (P=0.001).

Conclusions: The intervention promoting urinary continence reduced the prevalence of urinary incontinence after giving birth, particularly its severity, and promoted the performance of pelvic floor exercises at adequate levels; both continence and adherence to the programme were measured at three months after delivery in women who had forceps or ventouse deliveries or babies weighing 4000 g or more.

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Figures

Figure 1
Figure 1
Components of intervention promoting continence
Figure 2
Figure 2
Study procedures
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References

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