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Clinical Trial
. 2004 Aug 14;329(7462):378-80.
doi: 10.1136/bmj.38163.724306.3A. Epub 2004 Jul 14.

Randomised controlled trial of pelvic floor muscle training during pregnancy

Kjell A Salvesen  1 , Siv Mørkved
Affiliations
Clinical Trial

Randomised controlled trial of pelvic floor muscle training during pregnancy

Kjell A Salvesen et al. BMJ. .

Abstract

Objectives: To examine a possible effect on labour of training the muscles of the pelvic floor during pregnancy.

Design: Randomised controlled trial.

Setting: Trondheim University Hospital and three outpatient physiotherapy clinics in a primary care setting.

Participants: 301 healthy nulliparous women randomly allocated to a training group (148) or a control group (153).

Intervention: A structured training programme with exercises for the pelvic floor muscles between the 20th and 36th week of pregnancy.

Main outcome measures: Duration of the second stage of labour and number of deliveries lasting longer than 60 minutes of active pushing among women with spontaneous start of labour after 37 weeks of pregnancy with a singleton fetus in cephalic position.

Results: Women randomised to pelvic floor muscle training had a lower rate of prolonged second stage labour (24%, 95% confidence interval 16% to 33%; 22 out of 105 women were at risk (undelivered) at 60 minutes in the survival analysis) than women allocated to no training (38% (37/109), 28% to 47%). The duration of the second stage was not significantly shorter (40 minutes v 45 minutes, P = 0. 06).

Conclusions: A structured training programme for the pelvic floor muscles is associated with fewer cases of active pushing in the second stage of labour lasting longer than 60 minutes.

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Figures

Fig 1
Fig 1
Flow of participants through the trial
Fig 2
Fig 2
Survival plot of the duration of the second stage of labour for women in the training group (n=105) and the control group (n=109). Discrepancies in numbers are due to some missing data in each group (six in the training group and four in the control group). Operative deliveries for fetal distress (n=9) and slow progress (n=3) during the first hour, and all deliveries lasting longer than 60 minutes (n=59) were censored. Log rank test, P=0.06 for comparison of the two survival plots in the Kaplan-Meier analysis
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References

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