Urinary incontinence in pre/postpartum period and effectiveness of pelvic floor muscle training

Background The prevalence of urinary incontinence (UI) during pregnancy is between 32% and 64%. Regardless of type, European Urological Association recommends pelvic floor muscle training as the first stage treatment method. The aim of this study is (1) to determine the frequency, type, severity and risk factors of UI in the prepartum and postpartum period and then, (2) to determine the change of UI from the prepartum to the postpartum period and (3) to evaluate the efficacy of pelvic floor muscle training in primiparous postpartum women. Methods The first-phase of the study is cross-sectional, the second is an intervention study. The 384 pregnant women between 36-40 gestational weeks were taken into the study. They were also reached at the postpartum 4-8 weeks. ICIQ-SF Questionnaire and King's Health Questionnaire were administered. At the intervention phase, the 29 primiparous postpartum women with UI were randomly separated into intervention and control groups. Pelvic floor muscle training for the intervention group was given at the homes of the participants during the midwives for 4 weeks. Three months after the intervention, the ICIQ-SF Questionnaire, and the King's Health Questionnaire were administered to both groups. Results At any period of the pregnancy, the UI frequency is 41.7% and 19.1% in the postpartum 0-8 weeks. The most frequent type was the stress UI in both periods. Multiparity, BMI over 30, vaginal delivery, and smoking were identified as risk factors. There is a significant difference between the intervention and control groups in favor of the symptom frequency, symptom severity and quality of life. Conclusions UI is a very common problem for women during pregnancy. Pelvic floor muscle training is observed as a reliable method for treatment of the symptoms in the postpartum period. This method is easy to learn, effective, cost-free and should be integrated into reproductive health activities in primary health services. Key messages: Urinary incontinence is nearly a problem for one of two pregnant women and one of five after delivery. Pelvic floor muscle training is a very effective method and should be taught during pregnancy follow-ups.