title: Impact of delivery mode on electromyographic activity of pelvic floor: comparative prospective study.
abstract: OBJECTIVE
  Several studies evidenced the association between pregnancy, mode of delivery and genitourinary symptoms. However, there are still controversies about the role of mode of delivery in the prevention or aggravation of these symptoms. This study aimed to compare the impact of three distinct modes of delivery on pelvic floor muscle contractility.
  
  
  METHODS
  Seventy-five primiparous women were divided into three groups: (1) vaginal delivery with mediolateral episiotomy (n = 28); (2) elective cesarean section (n = 26); (3) emergency cesarean section (n = 21). All patients underwent vaginal digital examination, grading the muscle contractility from 0 to 5 and surface electromyography (EMG) of the pelvic floor during the last trimester of pregnancy and 45 days after delivery.
  
  
  RESULTS
  There was a significant increase in pelvic floor contractility in the elective cesarean section group, from 2.35 to 2.92 (P = 0.03), when compared to the vaginal delivery and emergency cesarean section groups. Analysis of electromyography data showed a significant reduction in maximum contraction of the pelvic floor after vaginal delivery, from 39.17 to 31.14 µV (P = 0.001), which was not observed in both cesarean section groups.
  
  
  CONCLUSIONS
  Vaginal delivery was associated with a decrease in pelvic floor muscle strength and endurance 45 days after delivery when compared to elective cesarean section as well as emergency cesarean section.
authors.affiliation: Pontifícia Universidade Católica de Minas Gerais, Poços de Caldas, MG, Brasil. botelhopereira@pucpcaldas.br
authors.forename: Simone
authors.initials: S
authors.lastname: Botelho
authors.forename: Cássio
authors.initials: C
authors.lastname: Riccetto
authors.forename: Viviane
authors.initials: V
authors.lastname: Herrmann
authors.forename: Larissa Carvalho
authors.initials: LC
authors.lastname: Pereira
authors.forename: César
authors.initials: C
authors.lastname: Amorim
authors.forename: Paulo
authors.initials: P
authors.lastname: Palma
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002585:Cesarean Section / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004576:Electromyography; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008137:Longitudinal Studies; D009119:Muscle Contraction; D053580:Muscle Strength; D010173:Palpation; D017773:Pelvic Floor / Q000503:physiopathology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult