The behaviour of pelvic floor muscles during uterine contractions in spontaneous and oxytocin-induced labour. 2018

Nazan Karahan, and Hediye Arslan, and Çetin Çam
a Midwifery Department, Faculty of Health Sciences , Karabuk University , Karabuk , Turkey.

Term pregnant women were divided into oxytocin infusion and control groups. The electrical activities of pelvic floor muscles (PFM) were recorded at rest and during contractions electromyographically. The beginning and the end of each contraction were marked on the recorded electromyographic trace. A trace was regarded as 'negative' if no increase in electrical activity was observed and 'positive' if increased electrical activity was observed during the contractions. To evaluate the relative frequency of the areas of electrical activity during uterine contractions (UC) a 'positive electrical activity percentage' was used and calculated as: (total count of positive electrical activity areas)/(total count of UC) × 100. Positive and negative electrical activity percentages were compared. The percentages were significantly different between the groups (p <.01). Positive traces increased in 56.1 and 18.8% in study and control groups, respectively, (p < .01). Multiparous women showed more positive traces than nulliparous women, both in oxytocin-treated and spontaneous labour groups (p < .01). The rate of performed episiotomies was higher in the oxytocin-infused labours (p = .01). During physiological labour contractions the predominant behaviour of PFM seemed to be a relative silent status compared to a more contractile status caused by oxytocin administration. Contracted muscles may produce a counterpressure against expulsive UC leading to obstetrical injuries of these muscles and clinically higher rates in episiotomy decisions. This is the first report of behaviour of PFM during labour contractions and further prospective studies are needed to assess the role of oxytocin administration on PFM and associated clinical consequences. Impact statement What is already known on this subject? The physiological functions of pelvic floor muscles depend on the coordinated actions of these muscles and rely also on unique interactions between the somatic and autonomic nervous systems. Oxytocin is commonly used for the induction and augmentation of uterine contractions and such an induced labour may be more painful for the woman. What do the results of this study add? Pelvic floor muscles tend to contract more frequently during uterine contractions as labour progresses. This difference was more pronounced in labours which were treated with oxytocin infusion. What are the implications of these findings for clinical practice and/or further research? This is the first report of electrophysiological behaviour of pelvic floor muscles during labour contractions in spontaneous and oxytocin-induced labour. Oxytocin administration seems to interfere with the coordination of uterine and pelvic floor muscle contractions. This study may be of interest for researchers to investigate the effect of the worldwide liberal use of oxytocin for induction of labour on pelvic floor muscle damage during parturition.

UI MeSH Term Description Entries
D007751 Labor, Induced Artificially induced UTERINE CONTRACTION. Induced Labor,Induction of Labor,Labor Induced,Labor Induction,Induced, Labor,Induction, Labor,Inductions, Labor,Labor Inductions
D010120 Oxytocics Drugs that stimulate contraction of the myometrium. They are used to induce LABOR, OBSTETRIC at term, to prevent or control postpartum or postabortion hemorrhage, and to assess fetal status in high risk pregnancies. They may also be used alone or with other drugs to induce abortions (ABORTIFACIENTS). Oxytocics used clinically include the neurohypophyseal hormone OXYTOCIN and certain prostaglandins and ergot alkaloids. (From AMA Drug Evaluations, 1994, p1157) Oxytocic,Oxytocic Agent,Oxytocic Drug,Uterine Stimulant,Uterine Stimulants,Oxytocic Agents,Oxytocic Drugs,Oxytocic Effect,Oxytocic Effects,Agent, Oxytocic,Agents, Oxytocic,Drug, Oxytocic,Drugs, Oxytocic,Effect, Oxytocic,Effects, Oxytocic,Stimulant, Uterine,Stimulants, Uterine
D010121 Oxytocin A nonapeptide hormone released from the neurohypophysis (PITUITARY GLAND, POSTERIOR). It differs from VASOPRESSIN by two amino acids at residues 3 and 8. Oxytocin acts on SMOOTH MUSCLE CELLS, such as causing UTERINE CONTRACTIONS and MILK EJECTION. Ocytocin,Pitocin,Syntocinon
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014590 Uterine Contraction Contraction of the UTERINE MUSCLE. Myometrial Contraction,Contraction, Myometrial,Contraction, Uterine,Contractions, Myometrial,Contractions, Uterine,Myometrial Contractions,Uterine Contractions
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control

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