Pregnancy, pelvic floor, barroreflex, heart rate
Conditions
Interventions
The women recruited for this study must be aged between 18 and 40 years, normal body mass index (BMI) for gestational age and have a first or second low-risk pregnancy. They will also be recruited non
group of pregnant women without training (PW) - a group of pregnant women not to perform the PMFT
and control group (CG) - the group of not pregnant women. Pregnant women will be distributed in groups with and without training by your own choosing, for ethical issue. Participants will be recruited
Behavioural
E02.779.483
G09.330.380.500.430
Sponsors
Universidade Federal de São Carlos
Universidade Federal de São Carlos
Eligibility
Sex/Gender
Female
Age
18 Years to 40 Years
Inclusion criteria
Inclusion criteria: 18 weeks of pregnancy;age group of 18 to 40; body mass index (BMI) for gestational age according to Atalah Table (Atalah SE et al, 1997).; first or second pregnancy.
Exclusion criteria
Exclusion criteria: High-risk pregnancy; drugs use; prolapse of pelvic organs; history of pelvic surgery; taking drugs that influence BP and HR (beta blockers; calcium channel inhibitors; anti anxiety drugs); vaginal palpation Intolerance (examination);inability to perform muscle contraction (P <2 according to PERFECT method Laycock& Jerwood (2001)); changes in the cardiovascular and respiratory systems; cardiovascular and diabetes diseases diagnosed.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Heart Rate Variability (HRV) and Blood Pressure Variability(BPV): These variables will be evaluated at the 19th and 36th week of gestation, and only once in the non-pregnant group to evaluate the influence of pregnancy, gestational time, contracting and training of the pelvic floor muscles in the variables. It is expected that the autonomic modulation is affected by pregnancy with less variability after postural change and contractions of the pelvic floor in pregnant women, and this greater attenuation in the third trimester. The ECG and peripheral pulse pressure signals will be recorded and stored, beat by beat, during the protocol of perineal exercises and postural change, for further analysis of HRV and BPV. The data will be considered in the frequency domain (linear art): very low frequency bands (MBF - between 0 and 0.04 Hz), low frequency (LF - between 0.04 and 0.15 Hz) and high frequency ( AF - between 0.15 and 0.40 Hz). In this study, we will use the bands LF and HF, which best represent the cardiac sympathetic and vagal modulation, respectively. These spectral components are expressed in absolute units (LF and HF) and in normalized units (LFnu and HFnu), and the LF / HF ratio (ratio between the bands of low frequency and high frequency), indicative of the sympathetic-vagal balance (Task Force, 1996). Symbolic Analysis (nonlinear technique: 1) 0V: no variation pattern [3 identical symbols, for example, (2,2,2) or (4,4,4)]; 2) 1V: pattern with a variation [2 following the same symbols and a different one, e.g., (4,2,2) or (4,4,3)]; 3) 2LV: 2 standard with equal variations [3 symbols form a ramp up or down, for example, (5,4,2) or (1,3,4)]; and 4) 2UV: standard with 2 different variations [3 symbols form a peak or a valley, for example, (4,1,2) or (3,5,3)]. The frequencies of occurrence of these families (0V%, 1W% 2LV% and 2UV%) will be evaluated. Shannon Entropy (nonlinear technique): to provide a qualification complexity of distribution patterns (Porta et al | — |
Secondary
| Measure | Time frame |
|---|---|
| Pelvic floor muscle function. These variable will be evaluated at the 19th and 36th week of gestation, and only once in the non-pregnant group to evaluate the influence of pregnancy, gestational time, and training of the pelvic floor muscles in pregnancy. It is expected that the training during pregnancy improves the function of the pelvic floor muscle. Muscle contraction will be assessed following the PERFECT protocol proposed by Laycock & Jerwood (2001) by vaginal palvação, always by the same examiner, graduating muscle function by Oxford scale modified. The perineometer Peritron device (Cardio Design Pty Ltd, Oakleigh, Victoria, Australia) has graduation 0-300 cmH2O and is equipped with a vaginal probe (28x55 mm). Three contractions of pelvic floor muscles will be performed. The average value of the three contractions will be used for data analysis (Bø et al., 1999). Surface electromyography will be held during abdominal contraction and maximal voluntary contraction (MVC) of the pelvic floor. For abdominal contraction and the MVC, the average and the highest RMSvalue will be counted and considered as the average and maximum voluntary electrical activity, respectively. The electromyographic activity will be normalized by the average and maximum RMS of abdominal contraction andbymaximumRMS of MVC.;Fetal Heart Rate Variability . Variability of the fetal heart rate. During maternal autonomic assessment will also be recorded fetal HRV parameters by cardiotocography for further analysis. We expected to find synchronicity between maternal and fetal parameters. | — |
Countries
Brazil
Contacts
Public ContactMikaela;Patricia da Silva Corrêa;Driusso
Universidade Federal de São Carlos;Universidade Federal de São Carlos
Outcome results
None listed