Labor Complications, Pelvic Floor Dysfunction, Pelvic Floor Muscle Training, Perineal Trauma
Conditions
Keywords
Pelvic Floor Muscle Training, Perineal Trauma, Obstetric Anal Sphincter Injury, Vaginal Birth, Second Stage of Labor, Postpartum Urinary Incontinence, Antenatal Exercise Program
Brief summary
This study aims to determine whether a structured pelvic floor muscle training program during pregnancy can reduce perineal trauma during vaginal birth. Nulliparous pregnant women at 28 weeks of gestation or later were invited to participate. Women who chose to join the training program performed supervised pelvic floor exercises twice weekly and daily home exercises. Women who declined the program received standard antenatal care. The study compared rates of severe perineal tears (third- or fourth-degree lacerations), episiotomy, the duration of the second stage of labor, postpartum urinary incontinence, and neonatal outcomes between the two groups. The goal of the study is to evaluate whether pelvic floor training can improve maternal and neonatal birth outcomes.
Detailed description
This prospective, patient-preference controlled clinical trial was conducted to evaluate whether a structured antenatal pelvic floor muscle training (PFMT) program can reduce perineal trauma and improve maternal birth outcomes. Low-risk nulliparous pregnant women at 28 weeks of gestation or later were invited to participate. Women who chose to participate in the training program formed the intervention group, while those who declined received standard antenatal care and served as controls. The intervention consisted of supervised PFMT sessions twice weekly, combined with a daily home-exercise program. Exercises followed a standardized protocol focusing on repeated maximal voluntary pelvic floor contractions with progressive increases in intensity. Adherence was monitored through attendance records and weekly follow-up. The study assessed severe perineal trauma (third- or fourth-degree tears) as the primary outcome. Secondary outcomes included episiotomy rate, duration of the second stage of labor, postpartum urinary incontinence, and neonatal outcomes. All participants provided written informed consent, and the study was approved by the institutional ethics committee. The findings aim to inform whether structured PFMT should be incorporated into routine antenatal care to support maternal pelvic floor health and improve labor outcomes.
Interventions
BEHAVIORALPelvic Floor Muscle Training Program
A structured antenatal pelvic floor muscle training program consisting of twice-weekly supervised sessions and a daily home-exercise routine from 20 to 34 weeks of gestation. Sessions included repeated maximal voluntary pelvic floor contractions following a standardized protocol with progressive intensity. Adherence was monitored through attendance logs and weekly follow-up.
Sponsors
Mehmet Incebıyik
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors who evaluated perineal trauma and neonatal outcomes were blinded to the participants' group assignments. All other study personnel and participants were aware of group allocation.
Intervention model description
Participants were assigned to one of two parallel groups based on patient preference: a pelvic floor training group and a standard care control group. Both groups were followed concurrently throughout the study period.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 36 Years
Healthy volunteers
Yes
Inclusion criteria
* Nulliparous pregnant women aged 18 to 36 years Singleton pregnancy Gestational age of 28 weeks or greater at enrollment Low-risk pregnancy without known obstetric complications Planning a vaginal delivery Able and willing to participate in supervised exercise sessions
Exclusion criteria
* Multiple gestation Placenta previa or other contraindications to vaginal birth Preeclampsia or gestational hypertension Diabetes requiring medication History of pelvic floor or urogenital surgery Neurological disorders affecting continence or pelvic floor function Inability to attend regular training sessions Refusal to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Severe Perineal Trauma (Grade 3-4) | At delivery | Severe perineal trauma is defined as third- or fourth-degree obstetric anal sphincter injuries (OASIS). Diagnosis is made by the attending clinician immediately after delivery using standard perineal examination and classification procedures. |
Countries
Turkey (Türkiye)
Outcome results
None listed