Prevelence of urinary incontinence in prepartum pregnancies, postpartum exchange and effectiveness of pelvic floor muscle training in postpartum urinary incontinence, in central Aydin

Aim and hypothesis: Study has two stages. The aim of cross-sectional study, which is the first stage; participants prepartum and postpartum period, the prevalence of the prepartum and postpartum urinary incontinence in which, urinary incontinence typing, symptom severity, symptom frequency, is to determine the effect on the relationship between risk factors and urinary incontinence quality of life. In addition, urinary incontinence prepartum with the changes in the postpartum period, to detect. The aim of the second stage, intervention work; in postpartum urinary incontinence, which is to evaluate the effectiveness of pelvic floor muscle training primipars. Methods: The study was conducted between November 2015 and December 2016. The first phase of the study was conducted at Aydın Kadın Doğum ve Çocuk Hastalıkları Hastanesi. The second phase was performed in the homes of the participants with postpartum urinary incontinence. In the first stage of work; Prepartum 384 pregnants between 36-40 gestational weeks were taken. The postpartum was reached by telephone between 4-8 weeks. Participatory questionnaires were applied in both periods. In the second phase of the study, 29 primipars, which were postpartum urinary incontinence, were obtained. Participants in the second phase were assigned to intervention and control groups and stratified randomization according to age and BMI was used. The ICIQ-SF and the King's Health Questionnaire were administered to those with urinary incontinence in the prepartum and postpartum period and in the evaluation of intervention outcomes. In the second phase of the study, the intervention group was given pelvic floor muscle training, which lasted for 4 weeks in the participants' homes at the time of the midwife. Three months after the intervention, the intervention and control groups were re-scaled. At the end of the intervention period, pelvic floor muscle training was given to the control group. Findings: In any period of pregnancy, the frequency of encountering with urinary incontinence was determined as 41.7%, and the frequency of urinary incontinence between 0-8 weeks postpartum was found as 19.1%. More stress type urinary incontinence were found in the presence of urinary incontinence during the prepartum period and during the postpartum period (40,7% and 52,6%, respectively). When the symptom frequency was questioned during the prepartum period and postpartum period, the number of those who missed two or three times a week was higher (30,1% and 47,5%, respectively). Symptom severity was questioned during the preparation period; (55.7%) in the postpartum period; (50.0%) were detected at a moderate level. In the prepartum period, the level of the effect of the urinary incontinence state on the daily life median/ min-max values is 4.0 / 1.0-10.0. In the postpartum period, the level of the effect of the urinary incontinence state on the daily life mean ± SD values is 3.8±0,9. There are 14 people with prevalence of urinary incontinence in both prepartum and postpartum period (3.6%). In these individuals, there is no difference between the two groups in terms of the type of urinary incontinence, symptom frequency, symptom severity, and the effect of urinary incontinence on quality of life. Results: Pelvic floor muscle training is the first-line treatment for women with stress or mixed type urinary incontinence. In addition, pelvic floor muscle training is the most reliable method of prevention and treatment during pregnancy and postpartum period. This method is easy to learn, effective, cost-free, reproducible throughout life, and applicable in every environment and condition. For this reason, pelvic floor muscle training can be easily disseminated in primary health care providers. Key words: urinary incontinence, prepartum, postpartum, pelvic floor muscle training, intervention