Effect of postpartum pelvic floor muscle training on improving pelvic floor function

Objective·To evaluate the effect of pelvic floor muscle training (Kegel training) on the rehabilitation of pelvic floor function within 1 year after delivery.Methods·From January to April 2020, primiparas with different degrees of urinary incontinence or pelvic organ prolapse were selected and divided into exercise group (147 cases) and control group (194 cases). The exercise group received Kegel training at 6 weeks of the postpartum period, while the control group received general postpartum health education only. At 6 weeks and 1 year after delivery, these postpartum women in the two groups were investigated with the general information questionnaire and International Consultation Incontinence Questionnaire-UI Short Form (ICIQ-SF). The pelvic floor muscle strength was measured (the pelvic floor muscle strength grade>Ⅲ indicates normal muscle strength). The pelvic organ prolapsed quantitation (POP-Q) score was assigned accordingly. The urinary incontinence score, pelvic floor muscle strength and pelvic floor organ prolapse were compared between the two groups, and the effect of pelvic floor muscle training was evaluated.Results·In the exercise group, 20 postpartum women lost contact during follow up sections, and 28 women in the control group were unable to be contacted within 1 year. In the exercise group, the proportion of women with normal pelvic floor muscle strength at 1 year postpartum was significantly higher than that at 6 weeks postpartum (56.0% vs 34.7%, P=0.000), and the incidence of incontinence at 1 year postpartum was significantly lower than that at 6 weeks postpartum (25.2% vs 36.7%, P=0.040). In the control group, the proportion of women with normal pelvic floor muscle strength at 1 year postpartum was significantly higher than that at 6 weeks postpartum (43.4% vs 32.5%, P=0.033), and the incidence of incontinence at 1 year postpartum was significantly lower than that at 6 weeks postpartum (17.5% vs 28.9%, P=0.011). At 1 year postpartum, the proportion of women with normal pelvic floor muscle strength in the exercise group was higher than that in the control group (56.0% vs 43.4%, P=0.033). The improvement rate of muscle strength in the exercise group was higher than that in control group (50.4% vs 35.5%, P=0.011). There was no significant difference in the improvement rate of pelvic organ prolapse and frequency of urinary incontinence between the exercise group and the control group (P>0.05).Conclusion·Postpartum pelvic floor muscle training can improve pelvic floor muscle strength, but has no significant effect on improving pelvic floor dysfunction in the current samples. The urinary incontinence condition and pelvic floor muscle strength of women improve 1 year after delivery, indicating that there is a mechanism for self recovery of pelvic floor muscle, but it may take a long time.