The effect of a comprehensive care and rehabilitation program on enhancing pelvic floor muscle functions and preventing postpartum stress urinary incontinence

Medicine (Baltimore). 2019 Aug;98(35):e16907. doi: 10.1097/MD.0000000000016907.

Abstract

This study was to investigate the incidence and the risk factors of postpartum stress urinary incontinence (SUI), and the effect of comprehensive care and rehabilitation program (CCRP) on preventing postpartum SUI.In stage I, 479 puerperae were recruited within 1 week postpartum, then the postpartum SUI incidence at 8th week and its risk factors were investigated. In stage II, 240 vaginal delivery puerperae were enrolled within 1 week postpartum and randomly assigned to CCRP group or control group as 1:1 ratio. The postpartum SUI incidence and pelvic floor muscle function indexes were evaluated at 8th week.In stage I, the postpartum SUI incidence was 25.7%, and SUI puerperae presented with higher body mass index (BMI), vaginal delivery rate, newborn weight, and larger newborn head diameter compared with non-SUI puerperae. Besides, the vaginal delivery, the elevated age and BMI were independent risk factors for postpartum SUI. In stage II, the postpartum SUI incidence in CCRP group was decreased compared with control group, and the vaginal resting pressure, vaginal squeezing pressure, and vaginal contraction duration were increased in CCRP group compared to control group at 8th week postpartum.The incidence of postpartum SUI is 25.7%, and the vaginal delivery, increased age, and BMI are independent risk factors for postpartum SUI. More importantly, CCRP strengthens pelvic floor muscle functions and decreases postpartum SUI incidence in puerperae.

MeSH terms

  • Adult
  • Body Mass Index
  • Cesarean Section / adverse effects
  • Comprehensive Health Care / methods*
  • Delivery, Obstetric / adverse effects
  • Female
  • Health Education / methods
  • Humans
  • Incidence
  • Maternal Age
  • Pelvic Floor / physiopathology
  • Postpartum Period
  • Pregnancy
  • Puerperal Disorders / epidemiology*
  • Puerperal Disorders / rehabilitation*
  • Random Allocation
  • Urinary Incontinence, Stress / epidemiology*
  • Urinary Incontinence, Stress / etiology
  • Urinary Incontinence, Stress / rehabilitation*