scholarly journals Bladder Base Displacement during Abdominal Muscles Contraction and Functional Activities in Primiparous Women Assessed by Transabdominal Ultrasound: A Descriptive Study

2021 ◽  
Vol 11 (1) ◽  
pp. 25
Author(s):  
Beatriz Arranz-Martín ◽  
Patricia García-Gallego ◽  
Helena Romay-Barrero ◽  
Beatriz Navarro-Brazález ◽  
Carlos Martínez-Torres ◽  
...  

This study described the response of the bladder base (BB) by transabdominal ultrasound in primiparous women during movements that activate the abdominopelvic cavity musculature and cause variations in intra-abdominal pressure (IAP). A descriptive cross-sectional study was conducted in 64 primiparous women at eight weeks after uncomplicated delivery. BB displacement was measured using a 5-MHz convex transducer in a suprapubic position. Participants were asked to perform the isolated contraction of pelvic floor musculature (PFM) and transverse abdominis (TrA), cough at high lung volume and trunk flexion with and without maximal voluntary contraction of PFM. PFM contraction elevated the BB in all but one participant, whereas TrA contraction caused the BB to ascend in 56% of the women and descend in the rest; their combined contraction rose the BB in 65% of the women although the effect was greater with only PFM contraction (p < 0.01). The BB descended in all participants during coughing and trunk flexion although the descent was inferior with the joint maximal voluntary contraction of PFM (p < 0.01). In conclusion, TrA contraction must be assessed individually in puerperal women since its effect on the BB varies among subjects. During movements increasing IAP, such as coughing or curl-ups, the anticipatory contraction of PFM reduces bladder descent although not sufficiently to counteract bladder displacement.

Author(s):  
Mercè Balasch-Bernat ◽  
Sofía Pérez-Alenda ◽  
Juan J. Carrasco ◽  
Begoña Valls-Donderis ◽  
Lirios Dueñas ◽  
...  

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women.


2021 ◽  
Author(s):  
Ulrike H. Mitchell ◽  
A. Wayne Johnson ◽  
Lauren Adams ◽  
Jade Kho ◽  
Daniel L. Belavy ◽  
...  

Abstract Background: Emerging evidence suggests that muscle function can be impaired in people with generalized hypermobility. The Beighton scale was developed to assess for the presence of hypermobility. This cross-sectional study assessed the activation of the lateral abdominal muscles in hypermobile (N=10; Beighton score >5) and matched non-hypermobile control (N=10) participants. Methods: Panoramic ultrasound scans of the transversus abdominis (TrA) and the external and internal abdominal obliques (EO and IO, respectively) were obtained at three lumbar levels (L1, L3, L5) at rest and during the hollowing maneuver. Results: Between-group differences in the TrA length, as well as TrA, EO and IO thickness changes between conditions (rest vs hollowing) and trunk strength and endurance were examined. Hypermobile participants exhibited less TrA shortening than controls (L1-L5: 5.1% difference, L3: 8.9% difference) and greater thickness changes at level L1 (12.7% difference). EO and IO thickness differed between groups for both conditions, where both of the muscles were 0.07cm - 0.18cm thicker at rest and 0.07cm - 0.19cm thicker with hollowing in the hypermobile participants compared to control (all: P<0.001). The ability to contract the EO was less in hypermobile participants compared to controls (P=0.002; -5.3% vs no change in thickness), while the ability to contract the IO was greater in hypermobile participants compared to in controls (P=0.038; +21.3% vs +17.6% thickness change). Hypermobile participants demonstrated over 30% greater average trunk flexion strength. Moreover, greater joint mobility was associated with less TrA muscle shortening, reduced EO thickness changes, greater isometric trunk muscle strength for both extension and flexion (all: P<0.001) and with reduced trunk muscle endurance for extension and flexion (P=0.006 and P=0.002, respectively). Conclusion: The results of this study indicate joint hypermobility is associated with reduced ability to contract TrA and EO, however, this did not appear to be associated with impaired function (e.g. muscle strength and endurance).


Author(s):  
Koshiro Haruyama ◽  
Shigemi Furiya ◽  
Takayuki Tsuzura ◽  
Seiichiro Hirano ◽  
Yosuke Yamaha ◽  
...  

2020 ◽  
Vol 12 (4) ◽  
pp. 1037-1042
Author(s):  
M. Jamaluddin ◽  
Widiyaningsih Widiyaningsih ◽  
Dwi Kustriyanti

During pregnancy there are physiological and psychological changes that can cause discomfort such as leg cramps, difficulty breathing, back pain, depression, anxiety and sleep disorders. The prevalence of low back pain is around 60-80% which can lead to strain on the ligaments and fatigue in the abdominal muscles, as well as balance disorders. This will lead to disruption of activities during pregnancy, such as difficulty walking and sleep disturbances. To assess low back pain and sleep quality among pregnant women: cross sectional study. Cross-sectional data were collected by 37 pregnant women with inclusion criteria were third trimester pregnant women, willing to be a respondent, with normal blood pressure, and have not received any medication related sleep disorder. They completed the Pittsburgh Sleep Quality Index (PSQI) and Rolland-Morris Disability Questionaire (RDQ), statistical analysis was conducted using Pearson Correlation Product Moment. Research was conducted in Semarang and Kudus. Sleep quality among pregnant women demonstrated significanly poor overall sleep quality with PSQI score (mean 8.70 ± 3.511) and RDQ score (mean 8.97 ± 6.414). There was moderate correlation between low back pain with sleep quality (r correlation = 0.558). Low back pain have correlation to increase or decrease sleep quality among preganant women. 


2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Budi I. Santoso ◽  
Suskhan Djusad ◽  
Surahman Hakim ◽  
Fernandi Moegni ◽  
Alfa P. Meutia ◽  
...  

Background: Perineal tear is the most common complication after vaginal delivery. Pill-rolling test is a widely used clinical evaluation method to determine the degree of perineal tear. However, the evaluation results of anal sphincter complex (ASC) differ between clinical examination and 2D/multislice transperineal ultrasonography (TPUS). This study aims to describe measurement variation between these modalities.Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2015 to May 2016. Subjects were primiparous women after vaginal delivery. Clinical examination using pill-rolling test was performed to determine the degree of perineal laceration. Suture was conducted accordingly. The subjects were subjected to 2D/multislice TPUS 72 hours after delivery to evaluate the integrity of internal and external anal sphincters. Data were collected and analyzed to determine compatibility between these examinations.Results: Among 70 prospective primiparous women, five were excluded due to unavailability to undergo 2D/multislice TPUS 72 hours after delivery. The mean duration to perform 2D/multislice TPUS was 4.5 minutes, and pain was tolerable during the examination. The compatibility values of clinical examination with 2D and multislice TPUS were 0.98 and 0.93, respectively, with Cohen’s kappa of 0.92 (95% CI 0.81–1.00) and 0.79 (95% CI 0.58–0.99), respectively.Conclusion: Clinical examination is compatible with 2D/multislice TPUS for determining the degree of perineal tear after vaginal delivery.


2020 ◽  
Author(s):  
Sabine Vesting ◽  
Monika Fagevik Olsén ◽  
Annelie Gutke ◽  
Gun Rembeck ◽  
Maria EH Larsson

Abstract Background Pregnancy and childbirth often result in alterations of core muscles, and women may require postpartum assessment of pelvic floor muscle function and abdominal wall changes, e.g. diastasis recti abdominis (DRA). However, there is currently no gold standard for postpartum assessment of these muscles´ function. Here we aimed to evaluate the reliability of clinically applicable methods for assessing pelvic floor muscles and DRA after pregnancy. Methods We recruited 222 postpartum women from Swedish antenatal and childbirth centers, and via social media. Pelvic floor and DRA assessment were performed via observation and palpation at three rehabilitation centers in Sweden. At each center, two independent physiotherapists performed the assessments in random order. Results Assessment of the maximal voluntary contraction and pelvic floor muscle endurance revealed kappa values ranging from 0.49–0.69. Assessments of voluntary contraction by observation, involuntary contraction, and voluntary relaxation yielded inconsistent results, with slight-to-moderate weighted kappa values ranging from 0.10–0.51. DRA assessment by caliper yielded ICC values of 0.73–0.83 after physiotherapists underwent 2 months of training in applying this assessment method. The standard error of measurements for this method was about 4 mm, and the minimal detectable change was 12 mm. Assessments of DRA depth and bulging showed moderate kappa values of 0.43–0.51, with reservation for some inconsistency between the centers. Conclusions Palpation of maximal voluntary contraction and pelvic floor muscle endurance are reliable postpartum assessment methods. With some experience and training, a caliper is a reliable instrument for assessing the postpartum DRA width. Additional research is needed to identify a reliable assessment method for pelvic floor muscle functions other than voluntary contraction, and for DRA depth and bulging.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue Tang ◽  
Lulu Ding ◽  
Yuejing Feng ◽  
Yi Wang ◽  
Chengchao Zhou

Abstract Background Reasonable use of antenatal care (ANC) services by pregnant women played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. This study aimed to investigate the ANC use, and to explore the factors associated with ANC use among migrant women during the first delivery in China. Methods This study used the data of National Health and Family Planning Commission of People Republic of China in 2014. A total of 1505 migrant primiparous women were included in our current analysis. Frequencies and proportions were used to describe the data. Chi-square tests and multivariate binary logistic regression models were performed to explore the determinants that affect the number of times migrant women used ANC during their first delivery. Results Of the 1505 participants, 279 (18.54%) women received the ANC less than 5 times, and 1226 (81.46%) women used the ANC at least 5 times during the first delivery. The multivariate logistic regression model showed that migrant primiparous women with college and above education(P < 0.05;OR = 2.57;95%CI = 1.19–5.55), from the households with higher monthly income (P < 0.01;OR = 2.01;95%CI = 1.30–3.13), covered by maternity insurance(P < 0.01;OR = 2.01;95%CI = 1.28–3.18), with maternal health records (P < 0.001;OR = 2.44;95%CI = 1.61–3.69), migrating across county (P < 0.05;OR = 2.57;95%CI = 1.14–5.81), having migration experience before pregnancy(P < 0.05;OR = 1.37;95%CI = 1.03–1.81) were more likely to use ANC for at least five times. Conclusions This study demonstrated that there were still some migrant maternal women (18.54%) who attended the ANC less than 5 times. Targeted policies should be developed to improve the utilization of ANC among migrant pregnant women.


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