A randomized trial of the effects of coached vs uncoached maternal pushing during the second stage of labor on postpartum pelvic floor structure and function

J. I. Schaffer, S. L. Bloom, B. M. Casey, D. D. McIntire, M. A. Nihira, K. J. Leveno

Research output: Contribution to journalArticle

72 Scopus citations

Abstract

Objective: The purpose of this study was to determine if refraining from coached pushing during the second stage of labor affects postpartum urogynecologic measures of pelvic floor structure and function. Study design: Nulliparous women at term were randomized to coached (n = 67) vs uncoached (n= 61) pushing. At 3 months' postpartum women underwent urodynamic testing, pelvic organ prolapse examination (POPQ), and pelvic floor neuromuscular assessment. Results: Urodynamic testing revealed decreased bladder capacity (427mL vs 482 mL, P = .051) and decreased first urge to void (160 mL vs 202 mL, P = .025) in the coached group. Detrusor overactivity increased 2-fold in the coached group (16% vs 8%), although this difference was not statistically significant (P = .17). Urodynamic stress incontinence was diagnosed in the coached group in 11/67 (16%) vs 7/61 (12%) in the uncoached group (P =.42). Conclusion: Coached pushing in the second stage of labor significantly affected urodynamic indices, and was associated with a trend towards increased detrusor overactivity.

Original languageEnglish (US)
Pages (from-to)1692-1696
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume192
Issue number5 SPEC. ISS.
DOIs
StatePublished - May 2005

Keywords

  • Coached pushing
  • Detrusor overactivity
  • Urinary incontinence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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