Development of a Midwifery care program during delivery for prevent urinary incontinence

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K12168
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Lifelong developmental nursing
• Research Institution: International University of Health and Welfare
• Principal Investigator: Katsuko Shinozaki 国際医療福祉大学, 福岡看護学部, 教授 (30331010)
• Co-Investigator(Kenkyū-buntansha): 江藤 宏美 長崎大学, 医歯薬学総合研究科(保健学科), 教授 (10213555)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 産後 / 尿失禁 / 助産ケア / 骨盤底筋群 / コアマッスル / 骨盤底機能

Outline of Final Research Achievements

From the viewpoint of preventing perinatal urinary incontinence, this study addressed urinary incontinence prevention using a new concept that includes not only the pelvic floor muscles but also the core muscles. The purpose of this study is to develop a midwifery care program during delivery to prevent urinary incontinence. This research was a descriptive comparative study. In the midwifery care program group, exercises to strengthen the core muscles were performed. At the time of delivery, the straight extension maternal position and pushing within 6 seconds were performed to minimize damage of the pelvic floor muscles. In the control group, normal pregnancy care and Valsalva maneuver in flexion during delivery were performed. We compared the dichotomized data between the absence and presence of urinary incontinence at 1 month postpartum. There was no significant difference in the rate of urinary incontinence between the 2 groups.

Free Research Field

医歯薬学

Academic Significance and Societal Importance of the Research Achievements

本邦の産後尿失禁発生率は、26.2～35.5％と報告されている。本邦の出産年齢は、年々上昇している。出産の高齢化は、分娩所要時間が遷延傾向にあり、骨盤底筋群の負担も大きくなる。現在の分娩時の姿勢は、脊柱を丸め努責を行うという方法が多くの施設で行われている。これは、コアの概念では、腹圧の負荷を骨盤底筋が直接受け、産後の尿失禁増加の可能性を高める。骨盤底筋群の損傷を最小限にするには、脊柱を伸展し自然な腹圧をかける努責が必要である。既に尿失禁が起こってから骨盤底筋群トレーニングを行うことは、機能回復に限界がある。骨盤底筋群の障害を最小限に抑えることが重要であり、この効果は女性のQOL向上に寄与する。