Análise da relação entre distensibilidade perineal, força da musculatura do assoalho pélvico e perda urinária em gestantes

Abstract

Urinary incontinence is a frequent dysfunction during pregnancy and postpartum, and is the subject of several scientific studies. The aim of this paper was to analyze the relation between distensibility and muscle strength in the incidence of this disorder in pregnant women. Observational, cross-sectional study conducted at the Pelvic Kinesio-Functional Performance and Women's Health Laboratory at the Federal University of Uberlândia. The volunteers were recruited by advertisements in newspapers, radio and social networks. Inclusion criteria were: age above 18 years; primiparous; gestational age 34 weeks; physiological gestation; medical authorization to perform the physical therapy intervention and desire to have vaginal delivery. Perineal distensibility was evaluated using the Epi-No® vaginal trainer. Muscle strength was assessed by vaginal manometry and digital vaginal palpation, and urinary issues through structured questions. A total of 155 primiparous pregnant women with gestational age between 33 and 34 weeks were evaluated. Correlation analysis showed that there is no correlation between perineal distensibility and daytime (r = 0.15; p = 0.85) and nighttime (r = -0.023; p = 0.79) urinary frequency. A slight negative correlation was observed between nocturnal urinary frequency and the maximum contraction of the pelvic floor muscles (r = -0.213; p = 0.010). No correlation was observed between daytime urinary frequency and maximal muscle contraction (r = 0.30 p = 0.714). It is concluded that there is no correlation between day and night urinary frequency and perineal distensibility in pregnant women in the third trimester. There is a slight negative correlation between nocturnal urinary frequency and muscle strength. The high prevalence of urinary loss indicated in the present study reinforces the need for the attention of the entire health team to prevent this dysfunction by training the pelvic floor muscles (PFM).