Evaluation Of The Effect Of Autonomous Pelvic Floor Muscle Exercise On Protecting Pelvic Floor Muscle Function During Pregnancy

Objective To investigate the effect of voluntary Kegel exercise during pregnancy on the structure and function of pelvic floor in primiparas in the early postpartum period.Methods Prospective study.Baseline data were collected from the primiparas who planned to undergo labor examination and delivery in Peking University Shenzhen Hospital.The subjects meeting the admission criteria were randomly divided into exercise group(Kegel exercise group during pregnancy)and control group after education.Control group of pregnant women according to the general diagnosis and treatment routine,no special intervention measures;The pregnant women in exercise group received pelvic floor muscle exercise under the guidance of specialists from 28 weeks of gestation to delivery,and the rest were the same as the control group.Establish the wechat group of the exercise group and supervise and guide the exercise group to conduct standardized pelvic floor muscle exercise in real time.1.The differences of age,BMI before and after pregnancy,thickness of detrusor muscle before pregnancy,length and thickness of perineal body,tear area of anal lifting muscle and probability of delivery mode were compared between the two groups.2.The incidence of early symptoms of pelvic floor muscle disorders before and after 6 weeks and 3months were compared between the two groups.3.The thickness of detrusor muscle,length and thickness of perineal body,and hiatus area of levator ANI were compared between the two groups before pregnancy and at 6 weeks and 3 months after delivery.The difference of ultrasonic measurements of pelvic floor between the two groups in Valsalva state at 6 weeks and 3 months after delivery was compared.4.The differences of prenatal and postpartum PISQ-12 quality of life questionnaire between the two groups were compared;5.The postpartum electrophysiological differences between the two groups were comparedResults 1.There were no significant differences in maternal age,prenatal and postpartum BMI,pregnancy,newborn weight and vaginal delivery rate between the two groups(all P values were greater than 0.05).2.There was no significant difference in manual muscle strength scores between the two groups at baseline(P > 0.05),but there was statistical significance at 6 weeks and 3 months postpartum(P < 0.05).The average muscle strength of the exercise group was higher than that of the control group at 6weeks and 3 months postpartum.There was no significant difference in the grading of POP-Q between 6 weeks postpartum and 3 months postpartum(P > 0.05).3.There were14 cases(21.2%)and 18 cases(27.3%)of different degree of sexual disturbance(sexual dissatisfaction,pain,dryness,decreased libido,etc.)at 6 weeks and 3 months postpartum respectively.At 6 weeks and 3 months postpartum,There was statistical significance in the incidence of sexual life disorder between the two groups(P<0.05),but no statistical significance in the incidence of SUI and POP(P>0.05).At 3 months postpartum,there was statistical significance in the incidence of sexual life disorder between the two groups(P < 0.05),but there was no statistical significance in the incidence of SUI and POP(P>0.05).When the data of 6 weeks and 3 months postpartum were compared between the two groups,it could be concluded that there was a statistically significant difference in the incidence of SUI between 6 weeks and 3months postpartum in the control group(P<0.05),but there was no statistical significance in the exercise group.4.There were no significant differences in detrusor muscle thickness,perineal body length,perineal body thickness and levator ANI tear area between the two groups in the baseline prenatal period(P>0.05).The thickness of detrusor muscle and length of perineal body were measured at 6 weeks and 3 months postpartum,and there were statistical differences between the two groups compared with the baseline period(P<0.05).There was no statistical significance in perineal body thickness or levator anal tear area between the two groups(P>0.05).There were statistically significant differences in bladder mobility and urethra rotation Angle between the two groups at 6 weeks postpartum under Valsalva condition(P < 0.05).There was no significant difference in the posterior bladder Angle(P>0.05),and the mean value of bladder mobility,urethra rotation Angle and posterior bladder Angle in the control group was greater than that in the experimental group.At 3 months postpartum,there were no significant differences in bladder mobility,urethral rotation Angle and posterior bladder Angle between the two groups(P>0.05).5.There was no significant difference in the scores of PISQ-12 between the two groups before delivery,but there was significant difference in the scores of PISQ-12 at 3 months after delivery(P<0.05).6.Compared with the electrophysiological parameters of the two groups,the average maximum muscle strength of class II muscle fibers of the pelvic floor muscle in the control group was lower than that in the experimental group,and the difference was statistically significant(P<0.05);When measuring the muscle strength of Class I and Class II muscle fibers,the average abdominal muscle participation of the control group was greater than that of the experimental group,and the difference was statistically significant(P<0.05).Conclusion Autonomous pelvic floor muscle exercise under the guidance of specialists during pregnancy can reduce the damage degree of pelvic floor muscle fiber during pregnancy and delivery.After mastering the essentials of pelvic floor muscle rehabilitation,the protective effect of Class II muscle fibers is more obvious.Pelvic floor muscle exercise during pregnancy can reduce the symptoms of postpartum pelvic floor muscle dysfunction,and the effect is more significant in the short term.