IMR Press / CEOG / Volume 50 / Issue 2 / DOI: 10.31083/j.ceog5002030
Open Access Original Research
Effects of Different Indications for Forceps Delivery on Pelvic Floor Muscle Surface Electromyography and Early Postpartum Pelvic Floor Function in Primiparas
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1 Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, China
2 Pelvic Floor Clinic Center, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, China
3 Department of Pathology, Tenth People’s Hospital of Tongji University, 200030 Shanghai, China
*Correspondence: superstarcxl@126.com (Xinliang Chen)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(2), 30; https://doi.org/10.31083/j.ceog5002030
Submitted: 4 November 2022 | Revised: 7 December 2022 | Accepted: 16 December 2022 | Published: 31 January 2023
(This article belongs to the Special Issue Delivery and Pelvic Floor Disorders)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Forceps-assisted vaginal delivery is closely associated with postpartum pelvic floor muscle (PFM) injury and postpartum pelvic floor dysfunction. The present study utilized Glazer PFM surface electromyography (sEMG) and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) for the objective assessment of postpartum PFM function to determine the effects of different forceps delivery indications on early postpartum pelvic floor function in primiparas. Methods: Four hundred primiparas whose pregnancies had been terminated by forceps delivery were divided into three groups based on the indication for forceps delivery: fetal distress (FD) (n = 260), prolonged second stage of labor (PSSL) (n = 30), and intrapartum fever combined with fetal distress (IFFD) (n = 110). Pelvic floor muscle surface electromyography (EMG) performed according to the Glazer protocol at 42–60 days postpartum was the primary outcome measure. Results: The overall Glazer assessment scores of the PSSL (54.4 ± 18.6) and IFFD (54.6 ± 15.8) groups were significantly lower than that of the FD group (59.3 ± 17.0) (p = 0.019). The peak EMG value during the fast-twitch stage for the FD, PSSL, and IFFD groups was 32.4 ± 17.7, 31.7 ± 26.1, and 26.5 ± 12.2 μV, respectively; the IFFD and FD groups were significantly different (p < 0.05). The incidence of postpartum stress urinary incontinence (SUI) was significantly higher in the IFFD and PSSL groups; the IFFD and FD groups were significantly different (p < 0.05). Conclusions: Intrapartum fever probably affects the early postpartum pelvic floor function of primiparas who underwent forceps delivery, which mainly manifests in the short term as reduced fast-twitch muscle strength and SUI.

Keywords
indications for forceps delivery
primipara
pelvic floor muscle dysfunction
surface electromyography
Glazer assessment
urinary incontinence
Funding
CR2018WX01/Project of National Natural Science Foundation of China
GFY1808004/Shanghai Municipal Key Clinical Specialty, Shanghai, China
Figures
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