title: Comparison of pelvic floor muscle strength between women undergoing vaginal delivery, cesarean section, and nulliparae using a perineometer and digital palpation.
abstract: OBJECTIVE
  To compare pelvic floor muscle (PFM) strength between women undergoing vaginal delivery, cesarean section, and nulliparae, investigating the factors associated with PFM strength, and observing the correlation between vaginal digital palpation and use of a perineometer.
  
  
  METHODS
  A cross-sectional study was conducted, including 31 women following vaginal delivery, 30 women following cesarean section, and 30 nulliparous women. PFM strength was measured by vaginal digital palpation and use of a perineometer. Multiple linear regression analysis with adjustment for covariables was used to compare the mean PFM strength and identify its associated factors.
  
  
  RESULTS
  The mean PFM strength of women undergoing vaginal delivery and cesarean section was 25.6 ± 14.5 cmH(2)O and 39.6 ± 22.0 cmH(2)O (p < 0.01, adjusted for covariables), respectively. A correlation was observed between measurements of PFM strength obtained by vaginal digital palpation and use of a perineometer (tau = 0.82; p < 0.01). The non-white race/ethnicity was negatively associated with PFM strength (coefficient: -10.2424; p = 0.02).
  
  
  CONCLUSIONS
  A lower PFM strength was observed in women with a history of vaginal delivery compared to those undergoing cesarean section. Non-white race/ethnicity negatively affected PFM strength. Our data suggest that vaginal digital palpation may be used in clinical practice because of its expressive correlation with use of a perineometer.
authors.affiliation: Department of Gynecology and Obstetrics, Universidade Federal de Goiás, Goiânia-GO, Brazil.
authors.forename: Elicéia Marcia
authors.initials: EM
authors.lastname: Batista
authors.forename: Délio Marques
authors.initials: DM
authors.lastname: Conde
authors.forename: Waldemar Naves
authors.initials: WN
authors.lastname: Do Amaral
authors.forename: Edson Zangiacomi
authors.initials: EZ
authors.lastname: Martinez
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D010173:Palpation; D010298:Parity; D017773:Pelvic Floor / Q000502:physiology*; D011247:Pregnancy; D012044:Regression Analysis