title: Assessment of foetal wellbeing in pregnant women subjected to pelvic floor muscle training: a controlled randomised study.
abstract: OBJECTIVE
  The objective was to assess foetal wellbeing in pregnant women subjected to pelvic floor muscle training (PFMT) by evaluating the acute and chronic effects of the procedure using the Doppler method.
  
  
  METHODS
  Ninety-six primigravidae with singleton pregnancies and at a low risk of pregnancy complications were randomised to either intervention with PFMT or no intervention. The final analysis included 26 women in the intervention group and 33 in the control group. Women from the intervention group were subjected to a daily PFMT program. Evidence of possible foetal risk was assessed by Doppler and the control group received standard care. The protocol was conducted from 20 to 36 weeks' gestation. The pulsatility indices (PI) of the uterine, umbilical and middle cerebral arteries were determined at 28, 32 and 36 weeks' gestation. The acute effects were determined by comparing the values obtained before and after exercise in the group subjected to PFMT and the chronic effects were determined by comparing the resting values of the trained group with those of the control group.
  
  
  RESULTS
  The results obtained showed normal values for the three gestational ages in both groups, with no difference between groups. Comparison before and after exercise showed a significant decline in the PI of uterine artery at 36 weeks without changes in the flow of umbilical and middle cerebral arteries.
  
  
  CONCLUSIONS
  Pelvic floor muscle training in low-risk primigravidae with singleton pregnancies was associated with a significant decline in PI of the uterine artery after exercise, while no significant changes in the flow of the middle cerebral and umbilical arteries were found. The PFMT may be recommended to women as a first-line measure to prevent of urinary incontinence during pregnancy.
authors: Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil.
authors: Marcos Massaru
authors: MM
authors: Okido
authors: Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil.
authors: Fabiana Lellis
authors: FL
authors: Valeri
authors: Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil.|School of Ultrasonography and Medical Recycling of Ribeirão Preto (EURP), Ribeirão Preto, Brazil.|National Institute of Science and Technology (INCT) of Hormones and Women's Health, Ribeirão Preto, Brazil.
authors: Wellington Paula
authors: WP
authors: Martins
authors: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil.
authors: Cristine Homsi Jorge
authors: CH
authors: Ferreira
authors: Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil.
authors: Geraldo
authors: G
authors: Duarte
authors: Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, 14049-900, Ribeirão Preto, SP, Brazil. rcavalli@fmr.usp.br.
authors: Ricardo Carvalho
authors: http://orcid.org/0000-0001-5010-4914
authors: RC
authors: Cavalli
mesh_terms: D000293:Adolescent; D000328:Adult; D026241:Exercise Movement Techniques; D005260:Female; D005333:Fetus / Q000098:blood supply; D006801:Humans; D017773:Pelvic Floor / Q000502:physiology*; D021041:Placental Circulation; D011247:Pregnancy; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000502:physiology*; D055815:Young Adult
keywords: Diaphragm of the pelvis; Exercise; Foetal suffering; Pregnancy; Urinary incontinence