Trauma Clinical Trial
Official title:
Perineal Muscle Training Versus Usual Prenatal Care in the Incidence of Avulsion of the Levator Ani Muscle at First Birth of Mexican Women: Randomized Control Trial
Levator Ani Muscle (LAM) avulsion occurs in 13-36% of women having their first birth. These
damages by palpation and ultrasound of the pelvic floor can be detected. Avulsion of the LAM
results in decreased muscle strength of the pelvic floor, enlarge the genital hiatus and
promotes pelvic organ prolapse. The perineal muscle training is a proposal to combine the
perineal massage with pelvic floor exercises in order to prepare the LAM in the last weeks
before delivery, to withstand stretching which will be submitted during childbirth. No
studies in the world that have explored the effect of the perineal muscle training on the
avulsion of MEA.
Objective: To quantify the proportion of primiparous that result with avulsion of LAM after
their first birth among those performing perineal muscle training from week 33 of gestation
and those with usual prenatal care.
This study will be performed in 228 primiparous. Previous informed consent they will be randomized in two groups: 1) perineal muscle training and 2) usual prenatal care. Pelvic floor will be evaluated before and after childbirth clinically and ultrasonographilly. The outcome variables will be: 1) avulsion LAM diagnosed by palpation and 2-3D pelvic floor ultrasound, 2) symptoms of pelvic floor dysfunction identified with standardized and validated Spanish PFDI-20 questionnaire, 3) changes dimension of the genital hiatus and perineal body, 4) accomplishment of perineal muscle training. Demographic variables (marital status, occupation, level of education, age, weeks of gestation, weight, height, BMI, religion, pathologies) and variables related to childbirth (weeks of gestation duration of the second period, use of analgesia, variety of position, episiotomy, forceps. dystocia, who attended the birth, weight and head circumference of the newborn, tearing report and who repairs the last one. ;
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