title: Comparison of pelvic floor muscle strength in nulliparous women and those with normal vaginal delivery and cesarean section.
abstract: OBJECTIVE
  Weakness of the pelvic floor is quite common among women, and may occur following childbirth. The aim of this study was to compare pelvic floor muscle strength in women of reproductive age who were nulliparous or who had a cesarean section or normal vaginal delivery.
  
  
  METHODS
  In this cross-sectional study, 341 women including 96 nulliparous women, 73 women with a history of normal vaginal delivery with and without episiotomy, and 172 women with a history of elective or emergency cesarean section were recruited randomly from public health centers in Ahvaz, Iran. Data were collected using a sociodemographic questionnaire and a checklist was used to record weight, height, body mass index, and pelvic floor muscle strength. Pelvic floor muscle strength was measured with the woman in the lithotomy position using a Peritron 9300 V perineometer. Data were analyzed using one-way analysis of variance, the least significant difference test and the chi-squared test.
  
  
  RESULTS
  The nulliparous women had the highest mean pelvic muscle strength (55.62 ± 15.86 cm H2O). Women who had vaginal delivery with episiotomy had the lowest pelvic muscle strength (32.71 ± 14 cm H2O). In nulliparous women pelvic floor muscle strength was higher than in women who had normal vaginal delivery with episiotomy (p < 0.001), but was not significantly different from that in women with normal vaginal delivery without episiotomy or in women with cesarean section (elective or emergency, p = 0.245).
  
  
  CONCLUSIONS
  Nulliparous women had the highest pelvic floor muscle strength and there was no significant difference in pelvic floor muscle strength between women with normal vaginal delivery and those with cesarean section.
authors.affiliation: Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, 13th East Kianpars Ave, 1st Eastern Maroon, No:46, Ahvaz, Iran.
authors.forename: Poorandokht
authors.initials: P
authors.lastname: Afshari
authors.affiliation: Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, 13th East Kianpars Ave, 1st Eastern Maroon, No:46, Ahvaz, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Dabagh
authors.affiliation: Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, 13th East Kianpars Ave, 1st Eastern Maroon, No:46, Ahvaz, Iran.
authors.forename: Mina
authors.initials: M
authors.lastname: Iravani
authors.affiliation: Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, 13th East Kianpars Ave, 1st Eastern Maroon, No:46, Ahvaz, Iran. parvinabedi@ymail.com.
authors.forename: Parvin
authors.initials: P
authors.lastname: Abedi
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007492:Iran; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D010298:Parity / Q000502:physiology*; D017773:Pelvic Floor / Q000502:physiology*; D011247:Pregnancy; D014621:Vagina / Q000502:physiology; D055815:Young Adult
keywords: Cesarean section; Normal vaginal delivery; Nulliparous women; Pelvic floor muscle strength