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Pelvic floor function and childbirth

      To the Editors:

      Klein et al. in their article on pelvic floor function after childbirth (Klein MC, Janssen PA, MacWilliam L, Kaczorowski J, Johnson B. Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth. Am J Obstet Gynecol 1997; 176: 403-10) claim that they were “unable to find another study that used the same perineometer that we had” and that “we were unable to find any published pregnancy or prepregnancy perineometry norms.” Thus their literature review failed to discover our studies using an identical instrument in which we validated the reproducibility and established normative data in nulliparous women
      • Thorp Jr, JM
      • Bowes Jr, WA
      • Droegemueller W
      • Wicker H
      Assessment of perineal floor function: electromyography with acrylic plug surface electrodes in nulliparous women.
      and examined the effects of delivery on surface electromyography performance.
      • Thorp Jr, JM
      • Jones LG
      • Bowes Jr, WA
      • Droegemueller W
      Electromyography with acrylic plug surface electrodes after delivery.
      Likewise, they describe our prospective, controlled study of midline episiotomy
      • Thorp Jr, JM
      • Bowes Jr, WA
      • Brame RG
      • Cefalo RC
      Selected use of midline episiotomy: effect on perineal trauma.
      as a “retrospective study.” Pelvic floor function after childbirth is an important field and I appreciate the contributions of Klein et al. I would encourage more thoroughness in their review of the literature.

      References

        • Thorp Jr, JM
        • Bowes Jr, WA
        • Droegemueller W
        • Wicker H
        Assessment of perineal floor function: electromyography with acrylic plug surface electrodes in nulliparous women.
        Obstet Gynecol. 1991; 78: 89-91
        • Thorp Jr, JM
        • Jones LG
        • Bowes Jr, WA
        • Droegemueller W
        Electromyography with acrylic plug surface electrodes after delivery.
        Am J Perinatol. 1995; 12: 125-128
        • Thorp Jr, JM
        • Bowes Jr, WA
        • Brame RG
        • Cefalo RC
        Selected use of midline episiotomy: effect on perineal trauma.
        Obstet Gynecol. 1987; 70: 260-262