Pelvic Floor Muscle Training For Prevention And Treatment Of Urinary Incontinence In Antenatal And Postnatal Women

OBJECTIVE:To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence.METHODS:We searched The Cochrane Central Register of Controlled Trials(CENTRAL),PubMed,EMbase,CBMdisc,CNKI,VIP,WANFANG DATABASE and web site of some clinical trials such as Clinical trials,Current controlled trials .Relevant journals were also hand searched to January 2010. We collected randomized controlled trials (RCT) comparing Pelvic floor muscle training (PFMT) with usual antenatal and postnatal care for antenatal and postnatal women. Study selection and quality assessment, data extraction and analyses were undertaken by two reviewers independently according to the Cochrane Handbook for Systematic Reviews of interventions. Meta-analyses were also performed.RESULTS:nine trials met the inclusion criteria. nine studies involving 2905 women contriributed to the analysis.Based on the trial reports. Pregnant women who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence three months after delivery (RR=0.68,95%CI0.49 to 0.95,P=0.02). Postnatal women who received PFMT were less likely than women who did not receive treatment or received usual postnatal care (RR=0.81,95%CI 0.66 to 0.99,P=0.04) to report urinary incontinence three months after delivery and 12 months after delivery (RR=0.87,95%CI 0.78 to 0.98,P=0.02).CONCLUSION:There is some evidence that PFMT in women having their first baby can prevent urinary incontinence postpartum. These and other uncertainties, particularly long-term effectiveness, require further testing.