PELVIC FLOOR MUSCLES TRAINING BY THE METHOD OF BIOLOGICAL FEEDBACK IN PRIMIGRAVIDAS AFTER VAGINAL DELIVERY

Basic risk factors, provoking pelvic floor muscle dysfunction are: pregnancy, vaginal delivery, obstetric trauma, systemic dysplasia of connective tissue. The frequency of the disease in women of reproductive age varies from 26 to 31%. All over the world, different modifications of Kegel’s exercise complexes are used for strengthening pelvic floor muscles. However, nowadays, there are no clear clinical guidelines, target circle of patients is not defined, there are no specific schemes of therapy and evidence base is absent. Health care providers don’t motivate women enough to perform pelvic floor muscles strengthening exercises regularly at home, they don’t use biofeedback method, as control.In results of our study, in comparison with other groups, women after first vaginal delivery with episiotomy had the lowest indi-ces of pelvic floor muscle strength. By the authors opinion, it might be caused by maximal perineal trauma during delivery. In this group usage of exercise complex for pelvic floor muscles strengthening with biofeedback significantly improves pelvic floor muscle contraction strength. Usage of exercise complex in women after first vaginal delivery without episiotomy did not have significant impact on pelvic floor muscle contraction strength.Indices of pelvic floor muscles contraction strength after 8 months postpartum don’t restore up to the indices before pregnancy. Further prolonged researches are required in order to define whether it is generally possible to restore completely postpartum functional opportunities of pelvic floor muscles.

беременность, роды, эпизиотомия, дисфункция мышц тазового дна, сила сокращений мышц тазового дна, послеродовое восстановление, мышцы тазового дна, метод биологической обратной связи, Pregnancy, delivery, episiotomy, pelvic floor muscles dysfunction, pelvic floor muscles contraction strength, postpartum recovery, pelvic floor muscles, biofeedback method

1. Ящук, А.Г. Генетические аспекты развития пролапса гениталий/ А.Г. Ящук// Российский вестник акушера-гинеколога. - 2008. - Т. 8, № 4. - С. 31-37

2. Доброхотова, Ю.Э. Дисфункция тазового дна у женщин репродуктивного периода, синдром релаксированного влагалища - необходимость реабилитации в послеродовом периоде/ Ю.Э. Доброхотова, Т.С. Нагиева// Российский медицинский журнал. - 2017. - № 15. - С. 1121-1124

3. Особенности хирургического лечения пациенток молодого возраста с тяжелыми формами пролапса гениталий/ М.В. Мгелиашвили [и др.]// Российский вестник акушера-гинеколога. - 2017. - Т. 17, № 6. - С. 49-52

4. Riva D., Minini D. Childbirth-related pelvic floor dysfunction/D.Riva, D.Minini// Italy: Springer, 2016. - P.25-33

5. Оценка тяжести пролапса гениталий у женщин репродуктивного возраста и возможности его нехирургической коррекции/О.В.Грищенко и [др.]// Таврический медико-биологический вестник. - 2012. - Т. 15, № 2:1. - С. 83-85

6. Davila W., Ghoinem G., Wexner S. Pelvic floor dysfunction, a multidisciplinary approach/ W.Davilla, G.Ghoinem, S.Wexner// USA: Springer, 2006. - P. 303-311

7. Радзинский, В.Е. Перинеология/ В.Е. Радзинский. - М.: МИА, 2006. - 336 с

8. Радзинский, В.Е. Перинеология. Опущение и выпадение половых органов: учебное пособие/В.Е. Радзинский, О.Н. Шалаев, Ю.М. Дурандин [и др.]. - М.: РУДН, 2008. - 311с

9. Дикке, Г.Б. Ранняя диагностика и консервативное лечение дисфункции тазового дна. Эффективная фармакотерапия/ Г.Б. Дикке//Акушерство и гинекология. - 2016. - Т 4. - С.3-10

10. Fourth international consultation on incontinence recommendations of the international scientific committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence/ Abrams P. [et al.]// Neurourology and Urodynamics, 2010. - Vol. 29, №1. - p. 213-240

11. The Long-Term Effectiveness of Antenatal Pelvic Floor Muscle Training: 8-Year Follow up of a Randomised Controlled Trial/ S.Ismail// BJOG: An International Journal of Obstetrics & Gynaecology, 2009. - Vol. 116, №4. P. 600-601

12. Can We Prevent Childbirth-Related Pelvic Floor Dysfunction?/ R. Freeman// BJOG: An International Journal of Obstetrics & Gynaecology, 2012. - Vol. 120, №2. - P. 137-140

13. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. / R. Boyle [et al.] //The Cochrane Library, 2012. - I. № 10 URL: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858. CD007471.pub3/full (дата обращения 19.08.18)

14. Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomised controlled trial of antenatal pelvic floor exercises/ E.Reilly [et al.]// BJOG: An International Journal of Obstetrics & Gynaecology, 2014. - Vol.121. - P. 58-66

15. Biofeedback: A Practitioner’s Guide. 4th ed. /M.S. Schwarts, F. Andrasik// New York: The Guilford Press, 2015. - 930 p