Espessura do reto abdominal como fator preditivo da incontinência urinária específica da gestação: estudo ultrassonográfico
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Data
2022-03-30
Autores
Magyori, Adriely Bittencourt Morgenstern
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: identificar a alteração da espessura do músculo reto abdominal durante as contrações isoladas e simultâneas dos músculos abdominais e do assoalho pélvico; bem como comparar a espessura do músculo reto abdominal entre gestantes com e sem incontinência urinária específica da gravidez (IU-EG). Desenho: Estudo transversal. Local: Centro de Pesquisas da Faculdade de Medicina de Botucatu. Participantes: Gestantes a partir de 19 semanas de gestação com e sem IU-EG foram recrutadas. Principais medidas de resultado: Espessura do músculo reto abdominal (MRA) medida em repouso e durante a contração do MRA, contração do músculo do assoalho pélvico (MAP) e contração simultânea do MRA e do MAP. Resultados: Foram incluídas 127 gestantes com IU-EG e 62 gestantes sem IU-EG. O IMC pré-gestacional e o IMC gestacional foram maiores no grupo IU-EG, enquanto a escolaridade foi menor neste grupo. A espessura de foi maior no grupo IU-EG quando medida em repouso e durante contrações voluntárias isoladas de e MAP. O espessamento da MRA a partir do repouso e durante uma contração voluntária isolada da MRA foi maior no grupo IU-EG. Conclusão: Maior escolaridade e atividade física durante a gestação mostraram-se fatores protetores. Maior IMC pré-gestacional, maior IMC gestacional e maiores espessuras de RAM em repouso, durante a contração voluntária isolada da MRA, durante a contração voluntária isolada dos MAP e seus valores de maior variação mostraram-se fatores de risco para IU-EG.
Objective: to identify the change in the rectus abdominis muscle thickness during both isolated and simultaneous abdominal and pelvic floor muscles’ contractions; as well as to compare the rectus abdominis muscle thickness between pregnant women with and without pregnancy-specific urinary incontinence (PS-UI). Design: A cross-sectional study. Setting: Research Center of Botucatu Medical School. Participants: Pregnant women from 19 weeks of gestation with and without PS-UI were recruited. Main Outcome Measures: Rectus abdominis muscle (RAM) thickness measured at rest and during RAM contraction, pelvic floor muscle (PFM) contraction and simultaneous RAM and PFM contraction. Results: One hundred twenty-seven pregnant women with PS-UI and 62 pregnant women without PS-UI were included. Pre-gestational BMI and gestational BMI were higher on PS-UI group, while educational level was lower in this group. RAM thickness was greater in the PS-UI group when measured at rest and during isolated voluntary contractions of both RAM and PFM. Thickening of the RAM from rest and during an isolated RAM voluntary contraction was greater in the PS-UI group. Conclusion: Higher education levels and physical activity during pregnancy were shown to be protective factors. Higher pre-pregnancy BMI, higher gestational BMI, and higher RAM thicknesses at rest, during isolated RAM voluntary contraction, during PFM isolated voluntary contraction and its greater variation values were shown to be risk factors for PS-UI.
Objective: to identify the change in the rectus abdominis muscle thickness during both isolated and simultaneous abdominal and pelvic floor muscles’ contractions; as well as to compare the rectus abdominis muscle thickness between pregnant women with and without pregnancy-specific urinary incontinence (PS-UI). Design: A cross-sectional study. Setting: Research Center of Botucatu Medical School. Participants: Pregnant women from 19 weeks of gestation with and without PS-UI were recruited. Main Outcome Measures: Rectus abdominis muscle (RAM) thickness measured at rest and during RAM contraction, pelvic floor muscle (PFM) contraction and simultaneous RAM and PFM contraction. Results: One hundred twenty-seven pregnant women with PS-UI and 62 pregnant women without PS-UI were included. Pre-gestational BMI and gestational BMI were higher on PS-UI group, while educational level was lower in this group. RAM thickness was greater in the PS-UI group when measured at rest and during isolated voluntary contractions of both RAM and PFM. Thickening of the RAM from rest and during an isolated RAM voluntary contraction was greater in the PS-UI group. Conclusion: Higher education levels and physical activity during pregnancy were shown to be protective factors. Higher pre-pregnancy BMI, higher gestational BMI, and higher RAM thicknesses at rest, during isolated RAM voluntary contraction, during PFM isolated voluntary contraction and its greater variation values were shown to be risk factors for PS-UI.
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Palavras-chave
Músculo reto abdominal, Cocontração, Assoalho pélvico, Ultrassonografia, Incontinência urinária específica da gestação, Espessura