title: Postpartum pelvic floor muscle training and pelvic organ prolapse--a randomized trial of primiparous women.
abstract: OBJECTIVE
  Pelvic organ prolapse (POP) is a common and distressing condition. The aim of the present study was to evaluate the effect of pelvic floor muscle training (PFMT) on prevention and treatment of symptoms and signs of POP in primiparous postpartum women.
  
  
  METHODS
  This was a parallel group assessor blind randomized controlled trial. One hundred seventy-five primiparous postpartum women, mean age 29.8 years (standard deviation 4.1), stratified on major levator ani defects or no defect diagnosed by 3-/4-dimensional ultrasound, participated in a 4-month PFMT starting at 6-8 weeks' postpartum or control. All participants had thorough individual instruction and assessment of ability to perform correct pelvic floor muscle contractions. The PFMT group followed a supervised, weekly group training program and performed 3 sets of 8-12 daily maximal contractions at home. Main outcome was POP stage II or greater assessed by POP quantification and bladder neck position assessed by 3-/4- dimensional transperineal ultrasonography. Secondary outcome was symptoms of vaginal bulge using International Consultation on Incontinence Vaginal Symptoms questionnaire.
  
  
  RESULTS
  Ninety-six percent of the intervention group adhered to ≥80% of both group and home training sessions. At postintervention, there was no significant risk difference in POP (rational ratio, 1.62; 95% confidence interval, 0.55-4.75), bladder neck position or symptoms of vaginal bulging.
  
  
  CONCLUSIONS
  No effect was found of postpartum PFMT on POP in primiparous women. More randomized controlled trials are needed before strong conclusions can be drawn on the effect of PFMT on POP in the particular population.
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. Electronic address: kari.bo@nih.no.
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Gunvor
authors.initials: G
authors.lastname: Hilde
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Faculty of Medicine, University of Oslo, and Akershus University Hospital, Oslo, Norway.
authors.forename: Jette
authors.initials: J
authors.lastname: Stær-Jensen
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Faculty of Medicine, University of Oslo, and Akershus University Hospital, Oslo, Norway.
authors.forename: Franziska
authors.initials: F
authors.lastname: Siafarikas
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Merete Kolberg
authors.initials: MK
authors.lastname: Tennfjord
authors.affiliation: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway; Faculty of Medicine, University of Oslo, and Akershus University Hospital, Oslo, Norway.
authors.forename: Marie Ellstrøm
authors.initials: ME
authors.lastname: Engh
mesh_terms: D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D010298:Parity; D017773:Pelvic Floor; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D049590:Postpartum Period; D011247:Pregnancy; D016037:Single-Blind Method
keywords: exercise; pelvic floor muscle training; pelvic organ prolapse; postpartum; prevention