This study aims to assess the validity of preventive pelvic floor exercise (PFE) for pregnancy-related stress urinary incontinence (SUI) and for the restoration of postpartum pelvic floor muscle strength. PFE is an accepted component of antenatal care. It is a non-invasive, non-pharmacological nursing intervention that has the potential to lessen perineal trauma resulting from pregnancy and childbirth. A well-exercised pelvic floor musculature may more effectively support the proximal urethra, more readily accommodate the passage of the infant, and more rapidly regain function in the postpartum. Preliminary work has shown that postpartum pelvic muscle strength is related to the incidence of SUI. However, currently there is no clear empirical evidence to support the contribution of PFE to postpartum pelvic muscle strength or the incidence of SUI. This is a randomized clinical trial of postpartum pelvic floor outcomes using one intervention and one non-treatment control group; outcomes will be evaluated by a clinician blind to group assignment. Three hundred primigravid and secundagravid women will be recruited. Baseline data on pelvic floor muscle status and SUI signs and symptoms will be collected at 20 weeks gestation. Repeated measures will be obtained at 35 weeks gestation and at 6 weeks, 5 months, and 12 months postpartum. Relationships between antepartal PFE and postpartum pelvic muscle strength and the incidence of SUI will be tested. Thus, this study will strengthen the research base for the nursing practice of teaching PFE and contribute to the scientific literature about health promotion and disease prevention. Nursing has a long tradition of using physical procedures as an opportunity for client education. A vaginal examination provides an excellent experience in which a woman can learn about proper PFE technique and the benefits of this practice. Nurses also monitor postpartum perineal status and counsel women about self-care practices. Thus, this area is especially salient to nurses because they are ideally situated to disseminate knowledge about the contribution of PFE to the health of childbearing women.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29NR001950-02
Application #
3476337
Study Section
Nursing Research Study Section (NURS)
Project Start
1990-06-01
Project End
1995-05-31
Budget Start
1991-06-01
Budget End
1992-05-31
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Type
Schools of Nursing
DUNS #
791277940
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Sampselle, C M; Hines, S (1999) Spontaneous pushing during birth. Relationship to perineal outcomes. J Nurse Midwifery 44:36-9
Sampselle, C M; Miller, J M; Mims, B L et al. (1998) Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol 91:406-12
Sampselle, C M; Miller, J M; Herzog, A R et al. (1996) Behavioral modification: group teaching outcomes. Urol Nurs 16:59-63
Yeo, S; Sampselle, C (1996) Fiscally responsible research equipment purchases: a cost-containment approach. Nurs Res 45:377-8
Miller, J; Kasper, C; Sampselle, C (1994) Review of muscle physiology with application to pelvic muscle exercise. Urol Nurs 14:92-7
Brink, C A; Wells, T J; Sampselle, C M et al. (1994) A digital test for pelvic muscle strength in women with urinary incontinence. Nurs Res 43:352-6
Sampselle, C M (1993) Using a stopwatch to assess pelvic muscle strength in the urine stream interruption test. Nurse Pract 18:14-6, 18-20
Sampselle, C M; DeLancey, J O (1992) The Urine Stream Interruption Test and pelvic muscle function. Nurs Res 41:73-7