Authors (including presenting author) :
Ho LF (1), Fung MY(1), Wong SC(1), Leung PH(1), Lo WY (2), Yuen PMJ (2)
Affiliation :
(1) Obstetrics & Gynaecology Department, Princess Margaret Hospital, (2)Physiotherapy Department, Princess Margaret Hospital
Introduction :
About 30% of women report different degrees of urinary incontinence (UI) after childbirth. A local study had shown that 78.3% of women were not aware that UI was a disease entity. Although pelvic floor muscle exercise has been shown to be effective in strengthening the pelvic supportive muscles, and to reduce the incidence of UI. However, many women may not be aware or willing to seek advice.
Objectives :
To elucidate the incidence of UI and to examine the effectiveness and compliance of pelvic floor exercises at six weeks after delivery in our pregnant women by screening with a validated tool.
Methodology :
A one-month survey was conducted in October 2019, using the ICIQ-UI Short Form to identify the pregnant women who have UI during antepartum period. The questionnaire was distributed to all women attending our antenatal clinic at 35–37 weeks gestation. Women who had the symptoms of UI were referred to Physiotherapist immediately after delivery. Pelvic floor muscles exercises in form of ten cycles of exercises including squeezing and relaxation of perineal muscles to be done ten times daily was demonstrated and assessed by Physiotherapist. A pamphlet on prevention of UI and exercises information was also provided. Phone follow-up was conducted 6 weeks after delivery to check their compliance with and effectiveness of pelvic floor exercises.
Result & Outcome :
Of the 256 women recruited to constitute the final cohort, 50.4% (129/256) admitted to have leakage of urine during pregnancy (study group), and the other women constituted the comparison group. There was no differences between the two groups in age (p=0.312), parity (p=0.109), pre-pregnant body mass index (p=0.492), or infant birthweight (p=0.126). In the study group, 71.7% (91/127) were successfully contacted by phone 6 weeks after delivery. As suggested by physiotherapist, 10 cycles of exercises should be done 10 times per day. However, 41.8% (38/91), 47.3% (43/91) & 11.0% (10/91) had not practice, practiced < 5 cycles, and practiced >5 cycles per day respectively. Nevertheless, our data has been shown that the reduction of UI symptoms was correlated with postnatal exercise practiced in postpartum period (p=0.010, OR=4.2, 95% CI=1.299-13.723).This study suggested that pelvic floor muscles exercises should be promoted and advocated to reduce the incidence of UI symptoms after delivery.
