Força muscular do assoalho pélvico em mulheres submetidas ao parto vaginal, à cesárea e nulíparas

• Autor(a) principal: BATISTA, Elicéia Marcia
• Data de Publicação: 2010
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/1708
• topic: força muscular; perineômetro; exame vaginal digital; assoalho pélvico; 1. Força muscular 2. Perineômetro 3. Exame vaginal digital 4. Assoalho pélvico; muscle strength; perineometer; vaginal digital examination; pelvic floor; CNPQ::CIENCIAS DA SAUDE

Childbirth may determine pelvic floor modifications that may cause dysfunctions such as urinary/fecal incontinence and pelvic organ prolapse. Furthermore, delivery may be associated with a decrease in pelvic floor muscle (PFM) strength. Objectives: to compare PFM strength in women who delivered vaginally or by cesarean section and nulliparae, investigate the factors associated with PFM strength and demonstrate a correlation between measurements of PFM strength obtained by vaginal digital examination and by perineometer. Methods: a cross-sectional study was conducted, including 31 women following vaginal delivery, 30 following cesarean section and 30 nulliparae. PFM strength was investigated by vaginal digital examination (modified Oxford grading system) and by perineometer. Multiple linear regression analysis with adjustment for covariables was used to compare the mean PFM strength and identify factors associated with PFM strength. The Kendall test was applied to investigate the correlation between vaginal digital examination and a perineometer. Results: the mean age of the participants who delivered vaginally, underwent cesarean section and those who were nulliparous was 32.3±5.8 years, 30.5±5.4 years and 27.2±5.9 years (p<0.01), respectively. The mean PFM strength of women undergoing vaginal delivery and cesarean section was 25.6±14.5cmH2O and 39.6±22.0cmH2O (p<0.01, adjusted for covariables), respectively. A correlation between measurements of PFM strength obtained by vaginal digital examination and perineometer device was observed (tau=0.82; p<0.01). Non-white race/ethnicity was negatively associated with PFM strength (coefficient: -10.2424; p=0.02). Conclusions: women with a history of vaginal delivery had a lower PFM strength than those delivering by cesarean section. Non-white race/ethnicity negatively affected PFM strength. Our data suggest that vaginal digital examination may be applied in clinical practice because of its expressive correlation with a perineometer.