American Journal of Obstetrics & Gynecology
Volume 201, Issue 5 , Pages 529.e1-529.e6, November 2009

Change in urethral sphincter neuromuscular function during pregnancy persists after delivery

Presented at the 35th Annual Scientific Meeting of the Society of Gynecologic Surgeons, New Orleans, LA, March 30-April 1, 2009.

  • Alison C. Weidner, MD

      Affiliations

    • Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
    • ,
  • Mary M.T. South, MD

      Affiliations

    • Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
    • ,
  • Donald B. Sanders, MD

      Affiliations

    • Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC
    • ,
  • Sandra S. Stinnett, DrPH

      Affiliations

    • Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC

Received 30 December 2008; received in revised form 20 May 2009; accepted 8 July 2009. published online 23 September 2009.

Objective

The purpose of this study was to assess the effect of pregnancy and first vaginal delivery on urethral striated sphincter neuromuscular function.

Study Design

Quantitative electromyographic (EMG) interference pattern analysis of the urethral sphincter of 23 nulligravidas and 31 third trimester primigravidas allowed comparison of mean motor unit parameters before term vaginal delivery and postpartum.

Results

Mean electromyographic interference pattern parameters in the primigravidas were significantly lower than nulligravidas even antepartum, with decreased turns, lower amplitude, and less activity. The only significant change at 6 months' postpartum was further decline in number of turns resulting in a further decrease in turns:amplitude. All other electromyographic abnormalities persisted at 6 months' postpartum and remained abnormal compared to the nulligravidas.

Conclusion

Urethral sphincter neuromuscular function changed significantly during pregnancy and these changes persisted postpartum. Lack of recovery 6 months' postpartum suggests a physiologic impact of pregnancy itself on future risk of urinary incontinence.

Key words: electromyography, pelvic floor, pregnancy, urethra, urinary incontinence

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 Cite this article as: Weidner AC, South MMT, Sanders DB, et al. Change in urethral sphincter neuromuscular function during pregnancy persists after delivery. Am J Obstet Gynecol 2009;201:529.e1-6.

 Supported by NIH Grant HD38661-05 and the Charles Hammond Research Fund.

 Reprints not available from the authors.

PII: S0002-9378(09)00786-8

doi:10.1016/j.ajog.2009.07.022

American Journal of Obstetrics & Gynecology
Volume 201, Issue 5 , Pages 529.e1-529.e6, November 2009

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