Sphincter muscle activity before and after delivery: Does it
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There are ongoing discussions about whether the cesarean section is the safest mode of childbirth to prevent pelvic floor disorders. Pelvic floor electromyography (EMG) allows the analysis of external anal sphincter (EAS) function during voluntary contractions. The primary objective of this study was the evaluation of electromyography amplitude of external anal sphincter in women who had a vaginal delivery, compared to women who had a cesarean section. The secondary objective was to evaluate the anal incontinence score changes before and after delivery between the groups and to look for any relationship between the clinical and electromyography findings.

Multichannel surface electromyography was detected during maximal contractions in three sessions: (i) during pregnancy, (ii) 6?weeks after delivery and (iii) 1?year after delivery. Women were divided into two groups: cesarean section and vaginal delivery.

External anal sphincter electromyography amplitude decreases 6?weeks after vaginal deliveries from 10.1 to 8.6??V with effect size of 0.4, but returns to baseline after 1?year. No differences were observed between groups in all other variables.

No differences were observed after 1?year in electromyography activity between the two groups; however, a slight decrease of sphincter muscle amplitude was noted 6?weeks after vaginal delivery. The delivery mode does not have an effect on the external anal sphincter amplitude 1?year after delivery. Incontinence score slightly increased in both groups after delivery, with no significant differences between the two groups. No association was observed between the increase of incontinence score and the decrease of electromyography signal amplitude.

Source:https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.14587?af=R
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