Comparison of pelvic floor muscle strength in nulliparous women and those with normal vaginal delivery and cesarean section.

INTRODUCTION AND HYPOTHESIS: 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 H2 O). Women who had vaginal delivery with episiotomy had the lowest pelvic muscle strength (32.71 ± 14 cm H2 O). 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.