Análise funcional da musculatura do assoalho pélvico pós-parto em mulheres primigestas
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Data
2011-02-25
Autores
Gameiro, Luís Felipe Orsi [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Avaliar de forma subjetiva e objetiva a força muscular do assoalho pélvico (AP) em mulheres primigestas, na faixa etária de 20 a 30 anos, utilizando palpação vaginal, perineometria e eletromiografia (EMG), nos seguintes momentos: 20ª e 36ª semanas da gestação, aos 45, 90 e 180 dias após o parto. Foram estudadas na UNESP – Botucatu – SP, 50 primigestas saudáveis, sem queixas urinárias, na faixa etária de 20 a 30 anos, 36 completaram o estudo e realizaram avaliação funcional do assoalho pélvico, os achados foram correlacionados com possíveis alterações da continência urinária. Elas foram subdivididas na dependência do tipo de parto: Grupo 1 (G1): 17 mulheres submetidas a parto vaginal (PV), Grupo 2 (G2): 19 submetidas a parto cesárea (PC), foi feito questionário clínico, palpação bidigital vaginal, perineometria e eletromiografia (EMG) de contrações rápidas e sustentadas com o equipamento Myotrac Infiniti 3G. A média de idade do G1 foi de 22,8 anos e do G2 de 22,5 anos (p>0,05). O IMC foi de 24,76 e 25,13 kg/cm² em G1 e G2, considerado peso adequado (p>0,05). No G2, na 20ª semana de gestação, observamos perda de urina significativamente menor (5,8%) que no G1(35%), com diferença estatística entre os grupos (p<0,05). Em todo período de avaliação, observamos que houve aumento progressivo da perda urinária nos 2 grupos, sem diferença estatística entre os momentos (p>0,05). Na avaliação subjetiva (palpação vaginal) e objetiva (perineometria), observamos piora significativamente maior da força muscular (FM) do AP no G1 em relação ao G2 (p<0,05). Na EMG do AP, durante a contração rápida, houve diminuição significativa da FM na 36ª semana de gestação e no pós-parto, sem diferença entre os momentos no G1. No G2, a FM foi significativamente menor na 20ª semana de gestação, em comparação aos diferentes momentos. Na contração...
The aim of this study was to assess pelvic floor muscle strength (PFM) in primiparous women, using subjective and objective evaluation by vaginal palpation, perineometer and electromyography (EMG) in five moments as following: at the 20th and the 36th week gestation and after 45, 90 and 180 days of postpartum. Fifty healthy primiparous women with age between 20 and 30 years and without urinary complaints were evaluated at UNESP, Botucatu -SP. Thirty-six women completed the study and the functional analysis of pelvic floor muscle. Findings were correlated with possible disturbances of urinary continence. Participants were distributed according the childbirth in group 1 (n=17) for vaginal childbirth and group 2 (n=19) for cesarean. They fulfilled a clinical questionnaire and underwent transvaginal digital palpation (TDP), as well perineometer and eletromiography evaluation performed with Myotrac Infinit 3G. Muscle activity was measured at rest and force was obtained with three fast contractions and three sustained contractions. Mean age for G1 was 22.8 years and 22.5 years for G2 (p>0.05); body mass index was 24.7 and 25.1 Kg/m² for G1 and G2 respectively (p<0.05), both considered appropriate. On the 20th week of gestation G2 presented a urinary loss of 5.8% significant lower than G1 (35%); (p<0.05). During all period of study there was a gradual increase of loss urinary in both groups, without difference statistical between the moments (p>0.05). Subjective assessment (TDP) and objective evaluation by perineometer showed a greater worsening of PFM strength for G1 compared to G2 (p<0.05). EMG for fast contraction showed statistical decrease of PFM at the 36TH gestation week and on post-partum, without difference between moments for G1. While for G2 PFM was significantly lower at the 20th gestation week compared to different moments. In the sustained contraction there was a significantly... (Complete abstract click electronic access below)
The aim of this study was to assess pelvic floor muscle strength (PFM) in primiparous women, using subjective and objective evaluation by vaginal palpation, perineometer and electromyography (EMG) in five moments as following: at the 20th and the 36th week gestation and after 45, 90 and 180 days of postpartum. Fifty healthy primiparous women with age between 20 and 30 years and without urinary complaints were evaluated at UNESP, Botucatu -SP. Thirty-six women completed the study and the functional analysis of pelvic floor muscle. Findings were correlated with possible disturbances of urinary continence. Participants were distributed according the childbirth in group 1 (n=17) for vaginal childbirth and group 2 (n=19) for cesarean. They fulfilled a clinical questionnaire and underwent transvaginal digital palpation (TDP), as well perineometer and eletromiography evaluation performed with Myotrac Infinit 3G. Muscle activity was measured at rest and force was obtained with three fast contractions and three sustained contractions. Mean age for G1 was 22.8 years and 22.5 years for G2 (p>0.05); body mass index was 24.7 and 25.1 Kg/m² for G1 and G2 respectively (p<0.05), both considered appropriate. On the 20th week of gestation G2 presented a urinary loss of 5.8% significant lower than G1 (35%); (p<0.05). During all period of study there was a gradual increase of loss urinary in both groups, without difference statistical between the moments (p>0.05). Subjective assessment (TDP) and objective evaluation by perineometer showed a greater worsening of PFM strength for G1 compared to G2 (p<0.05). EMG for fast contraction showed statistical decrease of PFM at the 36TH gestation week and on post-partum, without difference between moments for G1. While for G2 PFM was significantly lower at the 20th gestation week compared to different moments. In the sustained contraction there was a significantly... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Eletromiografia, Diafragma da pelve, Incontinência urinária, Prigestas, Prophylaxis
Como citar
GAMEIRO, Luís Felipe Orsi. Análise funcional da musculatura do assoalho pélvico pós-parto em mulheres primigestas. 2011. 80 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2011.