The Effect of Pelvic Floor Muscle Training and Perineal Massage in Late Pregnancy on Postpartum Pelvic Floor Function in Nulliparas: A Randomised Controlled Clinical Trial

Objective: To evaluate the effects of pelvic floor muscle training (PFMT) and perineal massage during late pregnancy on postpartum pelvic floor function in nulliparas.

Design: Randomised controlled trial.

Setting: The Peking University First Hospital, a teaching hospital in China.

Participants: Two-hundred nulliparas were included.

Interventions: Nulliparas were randomised into four groups in a 1:1:1:1 ratio. Group A, control; group B, perineal massage; group C, pelvic floor muscle training (PFMT); group D, perineal massage and PFMT. The intervention group received the corresponding intervention from 34 weeks of gestation until delivery.

Measurements: Changes in pelvic floor function from 34 weeks of gestation to 6 weeks postpartum were assessed using pelvic floor electromyography (EMG), pelvic organ prolapse quantitation (POP-Q), and pelvic floor distress inventory-20 (PFDI-20).

Results: Those with PFMT (groups C and D) had a smaller decline in pelvic floor EMG of fibre II than those without PFMT (groups A and B) [- 0.2 (- 7.1, 11.3) µV vs 6.1 (- 0.2, 15.2) µV, P = 0.040]. The same scenario was observed in the pelvic floor EMG of fibre I. The Aa point measurement differences of those with PFMT (groups C and D) were smaller than those without PFMT (groups A and B) [0.0 (0.0, 2.0) cm vs 1.0 (0.0, 3.0) cm, P = 0.006]. The same result was observed for point Ba. No difference was observed in EMG and POP-Q in nulliparas with (groups B and D) or without perineal massage (groups A and C). No differences were observed in PFDI-20 scores.

Key Conclusions: PFMT during late pregnancy enhanced pelvic floor EMG, while perineal massage alone or PFMT combined with perineal massage did not.

Implications For Practice: PFMT in late pregnancy enhances pelvic floor function.