Original researchPelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial☆
Section snippets
Materials and methods
Nulliparous women attending the routine ultrasound control at The National Center for Fetal Medicine, Trondheim University Hospital, at 18 weeks’ pregnancy were invited to participate in the study. They received a written invitation and information about the study as a supplement to the letter inviting them to the routine ultrasound control. The women were asked to return a signed consent form if they wanted to participate in the study. Women were eligible for the trial if they were nulliparous
Results
In all, 301 nulliparous women were randomized to a training group (n = 148) or a control group (n = 153) (Figure 1). The trial groups were comparable at baseline (Table 1). Seven women in the control group and five women in the training group withdrew after the first assessment. The reasons for withdrawal were diseases connected to pregnancy (n = 6) or personal (n = 6) (eg, changes in work situation, familiar causes, relocation).
In all, 120 (81%) of 148 women in the training group followed the
Discussion
We found that intensive pelvic floor muscle training during pregnancy prevents urinary incontinence during pregnancy and after childbirth. We also found higher pelvic floor muscle strength at 36 weeks’ pregnancy (immediately after the end of the supervised training period) and 3 months after delivery in the training group.
This was an RCT of nulliparous women, with blinding of the investigator, a low dropout rate, the use of a standardized training protocol following recommendations from
References (30)
- et al.
Prevalence of stress urinary incontinence among women delivered by elective caesarean section
Int J Gynaecol Obstet
(1982) - et al.
The effects of birth on urinary continence mechanisms and other pelvic floor characteristics
Obstet Gynecol
(1998) - et al.
Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth
Obstet Gynecol
(1998) - et al.
Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobilityA randomised controlled trial of antenatal pelvic floor exercises
Br J Obstet Gynaecol
(2002) - et al.
Clinical predictors of urinary incontinence in women
Am J Obstet Gynecol
(1997) - et al.
Distress and delay associated with urinary incontinence, frequency, and urgency in women
BMJ
(1988) - et al.
Psychosocial impact of urinary incontinence in the community-dwelling population
J Am Geriatr Soc
(1990) - et al.
Exercise and incontinence
Obstet Gynecol
(1990) - et al.
Urinary incontinence in adultsAcute and chronic management
(1996) - et al.
Urinary incontinence during pregnancy in a racially mixed sampleCharacteristics and predisposing factors
Int Urogynecol J
(1996)
The frequency of urinary symptoms during pregnancy and puerperium in the primipara
Int Urogynecol J
Obstetric practice and the prevalence of urinary incontinence three months after delivery
Br J Obstet Gynaecol
Pelvic floor damage and childbirthA neurophysiological study
Br J Obstet Gynaecol
Effect of vaginal delivery on the pelvic floorA five year follow-up
Br J Surg
Do bladder neck mobility and urethral sphincter function differ during pregnancy compared with during the non-pregnant state?
Int Urogynecol J
Cited by (231)
Pelvic floor injury during vaginal birth is life-altering and preventable: what can we do about it?
2024, American Journal of Obstetrics and GynecologyRehabilitation of anterior knee pain in the pregnant athlete: Considerations and modifications by trimester
2023, Physical Therapy in SportExercise and pregnancy
2022, Fertility, Pregnancy, and WellnessPelvic Floor Muscle Training Effect in Sexual Function in Postmenopausal Women: A Randomized Controlled Trial
2021, Journal of Sexual MedicineCitation Excerpt :The verbal instruction given by the physiotherapist to women was for them to pull their PFMs in and up as strong as possible, and to hold the contraction for 6 seconds and then to relax completely. The protocol was performed in 4 positions: lying supine, sitting, kneeling on all fours and standing.26 Exercise sessions were supervised twice a week for 12 weeks by 2 trained women's health physiotherapists not involved with the assessments.
- ☆
The authors thank the physiotherapists Hildegunn Børsting, Trude Hoff Leirvik, Bente Olsen, Monica U. Tøndel, and Bjørg Vada for their efforts in performing this study, by leading the training groups. Professor of Biostatistics Ingar Holme, Norwegian University of Sport and Physical Education, and Associate Professor Stian Lydersen, Norwegian University of Science and Technology, gave valuable advice on the statistical analysis. The English revision of the manuscript was done by Nancy Lea Eik-Nes.
The work was funded by The Norwegian Fund for Postgraduate Training in Physiotherapy and the Norwegian Women’s Public Health Association.