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The pelvic floor muscles (PFM) are responsible for supporting the pelvic viscera and for promote urinary and fecal continence. Several studies observed the consequences of the perineal trauma during childbirth on the PFM, but there is lack of research in order to evaluate these muscles during pregnancy, so, although the physiological changes of pregnancy is known, there is not enough data on how these changes influence the PFM function. Therefore, this study aims to evaluate the functions of PFM during pregnancy and compare with nulliparous pelvic floor (PF) function. It is a cross-sectional study, observational, comparative, conducted between April and July 2015.The study population consisted of 141 women: 36 nulliparous (C group), 31 primiparous on first trimester pregnancy (1T group), 42 on second trimester (2T group) and 32 on third (3T group). The PF was evaluate by measuring the size of the genital hiatus (HG) and the perineal body (CP) and measuring the strength of the muscles through the bi-digital palpation (Pb), perineometry (Pe) and dynamometry (Din). The Levene test was used to check homogeneity of the samples regarding age, the Kruskal-Wallis test (ANOVA non-parametric) was applied on the variables to assess significant differences in the groups (C, 1T, 2T and 3T) and U test of Mann-Whitney for paired comparison. For correlation of the variables, we calculated the correlation coefficient by Spearman\'s Rank. The level of significance was establish at 0.05. Regarding the HG and CP variables, when comparing the groups, the lowest values were observed in C group (HG = 1.75cm and CP = 2.5cm) and increased in 3T group (HG = 2.25 cm and CP = 3, 5cm). Concerning the strength variables (Pb, Pe and Din) the initial study hypothesis was confirmed, with the group of nulliparous higher (Pb = 3.2; Pe = 45.6 cmH2O and Din = 1.2 kgf) of strength compared to the third trimester primiparous group (Pb = 2.1; Pe = 17.3 cmH2O and Din = 0.7 kgf). The correlation between the HG, CP and the strength measurements, demonstrated that the variable HG was not found and the CP was negatively correlated with Pe and Din (r = - 0.219 and r = - 0.228). Already comparing Pb variables, Pe and Din, it was possible to establish a positive correlation (Pb x Pe (r = 0.757); Pe x Din (r = 0.755) and Pb x Din (r = 0.564). For variables HG and CP, the highest numbers in 3T group were expected due to changes during pregnancy. The highest values for Pb, Pe and Din found in C group can also be explained when compared to lower values in 3T group, also for sustained changes by pregnant women. The positive correlation between the strength of assessment methods (Pb, Pe and Din) proven by this study, strengthened our results and concluded that there is a significant difference in PFM strength between primiparous on third trimester of pregnancy and nulliparous, suggesting pregnancy as a risk factor for reduction of the PFM strength. A musculatura do assoalho pélvico (MAP) é responsável por suportar as vísceras pélvicas e por promover a continência urinária e fecal. Inúmeros estudos publicados tem como enfoque as consequências do trauma perineal durante o parto sobre a MAP, mas há escassez de pesquisas que visem a avaliação dessa musculatura durante o período gestacional, ou seja, apesar de conhecidas as alterações fisiológicas da gravidez, faltam dados objetivos sobre como essas alterações influenciam a função da MAP. Para isso, esse estudo visa avaliar as funções da MAP durante a gestação e comparar com o assoalho pélvico (AP) de nuligestas. Tratou-se de um estudo transversal, observacional e comparativo, realizado entre abril e julho de 2015. A população do estudo foi composta por 141 mulheres:36 nuligestas (Grupo C), 31 primigestas de primeiro trimestre (Grupo 1T), 42 de segundo (Grupo 2T) e 32 de terceiro (Grupo 3T). O AP foi avaliado mensurando os tamanhos do hiato genital(HG) e do corpo perineal(CP) e medindo a força da musculatura através da palpação bidigital(Pb), da perineometria(Pe) e da dinamometria(Din). O teste Levene foi aplicado para verificar homogeneidade das amostras em relação a idade, o teste de Kruskal-Wallis (ANOVA não-paramétrica) foi aplicado nas variáveis para avaliar diferença significativa em relação aos grupos (C,1T, 2T e 3T) e o teste U de Mann-Whitney, para comparação em pares. Para correlação das variáveis foi calculado o Coeficiente de Correlação por Postos de Spearman. O nível de significância foi estabelecido em 0,05. Em relação as variáveis HG e CP, quando comparados os grupos, os menores valores foram observados no Grupo C (HG=1,75 cm e CP=2,5 cm) e maiores no Grupo 3T (HG=2,25 cm e CP=3,5 cm). Já em relação as variáveis de força (Pb, Pe e Din) a hipótese inicial do estudo foi confirmada, apresentando o grupo de nuligestas valores mais elevados (Pb=3,2; Pe=45,6 cmH2O e Din=1,2 kgf) de força em comparação ao grupo de primigestas de terceiro trimestre (Pb=2,1; Pe=17,3 cmH2O e Din=0,7 kgf). Na correlação entre as variáveis HG e CP, com as medidas de força, a variável HG não foi encontrada e o CP apresentou correlação negativa com Pe e Din (r = - 0,219 e r = - 0,228). Já comparando as variáveis Pb, Pe e Din, foi possível comprovar uma correlação positiva (Pb x Pe (r=0,757); Pe x Din (r=0,755) e Pb x Din (r=0,564). Para as variáveis HG e CP, os valores mais elevados no Grupo 3T eram esperados devido as alterações durante a gestação. A correlação positiva entre os métodos de avaliação de força (Pb, Pe e Din), comprovada por este estudo, fortaleceu os resultados encontrados e o presente trabalho pode concluir que há uma diferença significativa na força da MAP entre primigestas no terceiro trimestre de gestação e nuligestas, sugerindo a gestação como um fator de risco para redução da força do AP. Mestre em Ciências da Saúde

Aims We aimed to compare pelvic floor muscle (PFM) strength and sexual function in primigravid and non-pregnant women and compare PFM strength between those who exhibited and did not exhibit sexual dysfunction. Methods A cross-sectional observational study was conducted. The sample consisted of 154 women, including 76 primigravid and 78 non-pregnant women. The inclusion criteria were as follows: non-pregnant nulliparous women or primigravid women who were pregnant with a single foetus at least 14 weeks of gestational age and reported having sexual intercourse at least once during the last 4 weeks. The exclusion criteria were as follows: inability to contract the PFMs and prior urogynaecologic surgery. PFM strength was assessed via vaginal palpation (using the Modified Oxford Scale) and vaginal squeeze pressure (using the Peritron™ manometer). Sexual function was assessedusing the Female Sexual Function Index (FSFI) questionnaire. Sexual dysfunction was identified based on low FSFI scores.The data were analyzed using the Mann-Whiney and Spearman correlation tests. Results To discussion, primigravid women had lower FSFI scores and lower PFM strength than non-pregnant women. Women with sexual dysfunction had lower PFM strength than women without sexual dysfunction, as indicated by vaginal palpation (scores of 2 out of 5 and 4 out of 5, respectively; P

The objective was to evaluate the pelvic floor muscles (PFM) in primigravidae and compare them with those in nonpregnant nulliparous women. The sample consisted of 141 women with a mean age of 22.8 years, divided into four groups: 36 nonpregnant nulliparous (C), 31 primigravidae in the first trimester (1T), 42 primigravida in the second trimester (2T), and 32 primigravidae in the third trimester (3T). The participants were examined by digital palpation for pelvic floor muscle contraction using the Modified Oxford Scale, by measuring maximal vaginal squeeze pressure with a vaginal perineometer, and by measuring PFM maximal strength using a vaginal dynamometer. The best value of three maximal strengths was considered for analysis, the Kruskal–Wallis and Mann–Whitney U tests were used and differences were considered significant at p ≤ 0.05. The mean values for group C were 3.2 (digital palpation), 45.6 cmH2O (perineometry), and 11.7 N (dynamometry); for group 1T the corresponding values were 2.5, 21.1 cmH2O, and 8.8 N; for group 2T: 2.8, 22.9 cmH2O, and 7.8 N; and for group 3T: 2.1, 17.3 cmH2O, and 6.8 N. Groups were compared in pairs for digital palpation, perineometry, and dynamometry. There were significant differences between group C and group 1T, and between group C and group 3T. There was a significant difference between group C and group 2T with regard to perineometry and dynamometry, but not digital palpation. Dynamometry demonstrated a difference between groups 1T and 3T, digital palpation between groups 2T and 3T. Pelvic floor muscles in primigravidae are not as strong as those in nonpregnant nulliparous women.