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. 2018 Jul 3;18(1):275.
doi: 10.1186/s12884-018-1918-7.

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Yun Zhao  1 , Li Zou  2 , Mei Xiao  3 , Wan Tang  1 , Hai-Yi Niu  4 , Fu-Yuan Qiao  4
Affiliations

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Yun Zhao et al. BMC Pregnancy Childbirth. .

Abstract

Background: To investigate the effect of different delivery modes and related obstetric factors on the short-term strength of the pelvic floor muscle after delivery in Chinese primipara.

Methods: A total of 4769 healthy Chinese primiparas at postpartum 6-8 weeks were interviewed. According to the difference of delivery mode, the selected primiparas were divided into 2 groups, including cesarean delivery group containing 2020 and vaginal delivery group containing 2749. All the vaginal deliveries were further divided into 3 groups, including episiotomy group containing 2279, perineal laceration group containing 398, and forceps assisted group containing72. The scales of their pelvic floor muscle (PFM) strengths were examined by specially trained personnel using digital palpation (Modified Oxford scale:0-5 grade). According to participants' willingness, if the PFM strength was weak (0 or 1 grade), at-home PFM training would be recommended and an electrical stimulation combined with biofeedback therapy would be conducted for them in hospital. Twelve weeks after delivery, the PFM strength would be measured again. For statistical analysis, t-test, one-way variance analysis, Chi-square analysis, Kruskal-Wallis test H, Mann-Whitney U test and Wilcoxon test were carried out.

Results: The PFM strength in cesarean delivery group was higher than in vaginal delivery group (p < 0.05). Among 3 vaginal delivery groups, the PFM strength in perineal laceration group was the highest (p < 0.05); however, there was no difference in PFM strength between episiotomy group and forceps assisted group (p>0.05). After accepting PFM training at home and therapy in hospital, 305 women showed increased PFM strength (p < 0.05).

Conclusions: Vaginal delivery is an independent risk factor causing the damage of PFM, and episiotomy may cause injury of PFM. Through PFM training at home and therapy in hospital, those damage will resume as soon as possible in the short-time period after delivery.

Keywords: Biofeedback; Cesarean delivery; Eletrical stimulation; Episiotomy; Forceps; Pelvic floor muscle strength; Perineal laceration.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Ethics Committee of Maternal and Child Health Hospital of Hubei Province(201301) and all included women signed written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart demonstrating. The number of Participants who attended and the reasons for lost to follow-up
See this image and copyright information in PMC

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