Two year follow-up and comparison of pelvic floor muscle electromyography after first vaginal delivery with and without episiotomy and its correlation with urinary incontinence: A prospective cohort study
机构：[1]Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China[2]The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China云南省第一人民医院[3]Department of Obstetrics, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China外科片产科云南省第一人民医院[4]Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Hospital, Beijing, China[5]Department of Epidemiology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China[6]The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
IntroductionFew prospective studies have revealed the long-term neuromuscular alterations of pelvic floor after vaginal delivery. The aim of this study was to evaluate the impact of episiotomy on the electrical activity of pelvic floor muscle 2 years following vaginal delivery, and explore the relationship between surface electromyography (sEMG) amplitudes and urinary incontinence. Material and methodsA total of 427 primiparous women with full-term singleton vaginal delivery were included in the cohort and 362 with no further births within the 2 year follow-up completed observations. Of these, 200 underwent episiotomy and 162 underwent nonepisiotomy. Clinical demographic characteristics, vaginal EMG variables and urinary incontinence-specific questionnaire scores were collected at 6 weeks, 6, 12 and 24 months after childbirth, respectively. Primary outcomes were the comparison of sEMG values between the episiotomy and nonepisiotomy groups throughout 2 years. Secondary outcomes were the correlation between sEMG of both groups and the incidence and severity of urinary incontinence. Spearman's correlation analysis, Kruskal-Wallis test and ANOVA with Bonferroni correction were used to analyze the variables. ResultsAmplitude of maximal fast and endurance contractions on sEMG in the episiotomy group was significantly lower than the nonepisiotomy counterpart. Such difference of sEMG persisted for a long period after birth: endurance contraction, 33.12 +/- 8.92 versus 35.085 +/- 9.98, p < 0.01 at 24 months, and fast contraction, 36.53 +/- 8.87 versus 39.05 +/- 9.98, p = 0.01 at 12-month. Although there was no significant difference in incidence and severity of urinary incontinence between both groups, a negative correlation existed between EMG values of muscle contraction and urinary incontinence symptoms throughout. ConclusionsPrimiparous women delivered with episiotomy demonstrated lower contractile sEMG activity of pelvic floor muscle in the long term. The lower sEMG values of fast contraction were associated with urinary incontinence symptoms.
基金：
This study was funded by National High Level Hospital Clinical
Research Funding (Beijing Hospital Clinical Research 121 Project,
No. BJ-2018-
204),
National Natural Science Foundation of China
(No. 81302277), Yunnan Provincial Science and Technology
Department–2020
Kunming Medical University Joint Special
Project on Applied Basic Research (No. 202001AY070001-128)
and Academician Expert Workstation of Yunnan Province (No.
202005AF150033).
第一作者机构：[1]Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China[2]The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China[*1]Department of Gynecology and Obstetrics, Beijing Hospital, No. 1 Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China.
通讯作者：
通讯机构：[1]Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China[2]The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China[*1]Department of Gynecology and Obstetrics, Beijing Hospital, No. 1 Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China.
推荐引用方式(GB/T 7714)：
Li Min,Dong Xudong,Lyu Qiubo,et al.Two year follow-up and comparison of pelvic floor muscle electromyography after first vaginal delivery with and without episiotomy and its correlation with urinary incontinence: A prospective cohort study[J].ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA.2023,102(2):200-208.doi:10.1111/aogs.14487.
APA：
Li, Min,Dong, Xudong,Lyu, Qiubo,Li, Pingping,Lyu, Yuhan...&Liang, Yaxin.(2023).Two year follow-up and comparison of pelvic floor muscle electromyography after first vaginal delivery with and without episiotomy and its correlation with urinary incontinence: A prospective cohort study.ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA,102,(2)
MLA：
Li, Min,et al."Two year follow-up and comparison of pelvic floor muscle electromyography after first vaginal delivery with and without episiotomy and its correlation with urinary incontinence: A prospective cohort study".ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 102..2(2023):200-208
