%0 Journal Article
%T Perineal Distensibility Using Epi-no in Twin Pregnancies: Comparative Study with Singleton Pregnancies
%A Juliana Sayuri Kubotani
%A Antonio Fernandes Moron
%A Edward Araujo J¨²nior
%A Miriam Raquel Diniz Zanetti
%A Vanessa Cardoso Marques Soares
%A Julio Elito J¨²nior
%J ISRN Obstetrics and Gynecology
%D 2014
%R 10.1155/2014/124206
%X The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women¡¯s perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit. It was then withdrawn while inflated and its circumference was measured. The unpaired Student¡¯s -test was used to compare perineal distensibility in the two groups and Pearson¡¯s correlation coefficient ( ) was used to correlate the pregnant women¡¯s perineal distensibility with their anthropometric data. There was no difference in perineal distensibility between the twin group (16.51 ¡À 2.05£¿cm) and singleton group (16.13 ¡À 1.67£¿cm) ( ). There was a positive correlation between perineal distensibility and abdominal circumference ( ; ). The greater the abdominal circumference was, the greater the perineal distensibility was, regardless of whether the pregnancy was twin or singleton. 1. Introduction The term pelvic floor refers to all of the muscles, connective tissue, and organs that fill the cavity of the pelvic canal. The muscles of the pelvic floor form a diaphragm that encompasses the pelvic cavity. Their fibers have a U shape around the hiatus, which allows this to be constantly closed, thus providing pelvic support for the abdominal organs [1]. During pregnancy, with uterine growth, the pelvic floor becomes overloaded and, because of the influence of hormones and biomechanical changes to the pelvis, its tonus and strength diminish [2], and urinary symptoms can be observed even before delivery [3]. The Epi-no Delphine Plusvaginal dilator (Starnberg Medical, Tecsana GmbH, Munich, Germany) consists of an inflatable silicone balloon connected to a manometer via a rubber tube [4, 5]. In the absence of any instrument that could quantify this stretching, the Epi-no apparatus was adapted to objectively and quantitatively evaluate the degree of perineal distensibility. In twin pregnancies, the gestational changes are more pronounced, given that there are two fetuses, two placentas, and amniotic fluid for two fetuses, thus producing an even greater overload on the pelvic floor. From this supposition, the purposes of the present study were to compare the degree of distensibility of the musculature of the pelvic floor among women with twin pregnancies with
%U http://www.hindawi.com/journals/isrn.obgyn/2014/124206/