Randomised controlled trial of pelvic floor muscle training during pregnancy

doi:10.1136/bmj.38163.724306.3A

BMJ, doi: 10.1136/bmj.38163.724306.3A, (Published 14 July 2004)

PRIMARY CARE

Randomised controlled trial of pelvic floor muscle training during pregnancy

Kjell Salvesen ¹ Siv Mørkved ²

¹ Department of Obstetrics and Gynaecology, Trondheim University Hospital St. Olav, N-7006 Trondheim, Norway
² Department of Community Medicine and General Practice, Norwegian University of Science and Technology, N-7489 Trondheim, Norway

Objectives To examine a possible effect on labour of trainingthe muscles of the pelvic floor during pregnancy.

Design Randomisedcontrolled trial.

Setting Trondheim University Hospital and threeoutpatient physiotherapy clinics in a primary care setting.

Participants301 healthy nulliparous women randomly allocated to a traininggroup (148) or a control group (153).

Intervention A structuredtraining programme with exercises for the pelvic floor musclesbetween the 20th and 36th week of pregnancy.

Main outcome measuresDuration of the second stage of labour and number of deliverieslasting longer than 60 minutes of active pushing among womenwith spontaneous start of labour after 37 weeks of pregnancywith a singleton fetus in cephalic position.

Results Women randomisedto pelvic floor muscle training had a lower rate of prolongedsecond stage labour (24%, 95% confidence interval 16% to 33%;22 out of 105 women were at risk (undelivered) at 60 minutesin the survival analysis) than women allocated to no training(38% (37/109), 28% to 47%). The duration of the second stagewas not significantly shorter (40 minutes v 45 minutes, P=0.06).

Conclusions A structured training programme for the pelvicfloor muscles is associated with fewer cases of active pushingin the second stage of labour lasting longer than 60 minutes.

(Accepted 25 May 2004)

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