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Inicio Enfermería Clínica (English Edition) Effect of pregnancy and childbirth on perineal musculature in women with obesity...
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Vol. 33. Issue 6.
Pages 412-423 (November - December 2023)
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Vol. 33. Issue 6.
Pages 412-423 (November - December 2023)
Original Article
Effect of pregnancy and childbirth on perineal musculature in women with obesity. A longitudinal cohort study
Efecto del embarazo y el parto en la musculatura perineal de mujeres con obesidad. Un estudio de cohorte longitudinal
Manuel Martín Pinedaa,
Corresponding author
mamarpin@gobiernodecanarias.org

Corresponding author.
, Felipe Santiago Fernández Méndezb, Juan de Dios Gutiérrez Henaresa, Beatriz Rodríguez Villegasa, Nieves Luisa González Gonzáleza,c, Erika Padrón Péreza,c
a Servicio de Obstetricia y Ginecología, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain
b Departamento de Enfermería, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
c Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Publica, Toxicología, Medicina legal y Forense y Parasitología, Universidad de La Laguna, Santa Cruz de Tenerife, Santa Cruz de Tenerife, Spain
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Figures (2)
Tables (3)
Table 1. Biometric and socio-demographic sample data.
Table 2. Perinatal results.
Table 3. Results of perineal examination.
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Abstract
Objective

Evaluating the changes of the perineal muscles in primigravid women with obesity (BMI ≥ 30) and to compare the progress with primigravid women in normal BMI range.

Methods

A prospective longitudinal cohort study was carried out. The pregnant women were studied at three moments: at 12 weeks' gestation, at 34 weeks' gestation and at 12 weeks after delivery. During the ckeck-up, perinometric measurements were taken to determine basal tone (BT), maximum contractile force (FMax) and applied forced (AF). In addition, the Oxford test (MOS) was used. General statistical mixed models were used for the statistical study.

Results

Fifty nulliparous pregnant women (25 with BMI ≥ 30 and 25 with BMI < 25) were recruited at the beginning of the study and 39 completed the entire study. Basal tone (BT) was 4.62 ± 0.24 Nw at the beginning of pregnancy and decreased to 4.18 ± 0.26 Nw after delivery. Contractile capacity was 5.56 ± 0.79 Nw at week 12 and increased to 6.34 ± 1.24 Nw after delivery. When comparing the FCMax at week 12 in obese VS normal weight pregnant women, values of 5.51 ± 87 Nw vs. 5.61 ± 0.71 Nw were observed (P = .941). Postpartum values were 6.72 ± 1.17 Nw vs 5.95 ± 1.21 Nw (P = .024), higher in the obese population.

Conclusions

There is an increase in contractile strength (Fmax) at 12 weeks postpartum in order to counteract the significant decrease in basal tone (BT). The body has compensatory mechanisms that allow recovery after 3 months postpartum, with greater muscle strength in obese patients.

Keywords:
Pelvic floor disorders
Obstetric delivery
Pregnancy
Postpartum
Obesity
Resumen
Objetivo

Evaluar la evolución de la musculatura perineal en mujeres primigestas afectas de obesidad (IMC ≥ 30) y comparar dicha evolución con mujeres primigestas con IMC en rango de normopeso.

Método

Se realizó un estudio cohorte longitudinal prospectivo donde se estudió a las gestantes en 3 momentos: en semana 12 de gestación, la semana 34 de gestación, y a las 12 semanas tras el parto. En estas consultas se realizó medición mediante perinometría para determinar el Tono basal (TB), la Fuerza máxima Contráctil (FMax); y la Fuerza Ejercida (FE). Además, se utilizó el test de Oxford (MOS). Para el estudio estadístico se utilizaron modelos estadísticos generales mixtos.

Resultados

Se reclutaron al inicio 50 gestantes nulíparas (25 con IMC ≥ 30 y 25 con IMC < 25), concluyendo el estudio completo 39. Al inicio del embarazo el tono perineal basal fue de 4,62 ± 0,24 Nw y descendió a 4,18 ± 0,26 Nw tras el parto. La capacidad contráctil fue de 5,56 ± 0,79 Nw en la semana 12 y aumento a 6,34 ± 1,24 Nw tras el parto. Al comparar la FCMax en la semana 12 en gestantes Obesas VS Normopeso se observan valores de 5,51 ± 87 Nw vs 5,61 ± 0,71 Nw (P = 0,941). Se observaron valores postparto 6,72 ± 1,17 Nw vs 5,95 ± 1,21 Nw (P = 0,024), superiores en la población con obesidad.

Conclusiones

Existe una disminución significativa del tono basal que es contrarrestada con un aumento de la fuerza contráctil objetivable a las 12 semanas postparto. El organismo dispone de mecanismos compensadores que permiten la recuperación a partir de los 3 meses postparto existiendo una mayor fuerza muscular dentro de las pacientes con obesidad.

Palabras clave:
Disfunciones de suelo pélvico
Parto
Embarazo
Postparto
Obesidad

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