Vaginal digital palpation is a simple and effective method to evaluate functional pelvic floor muscle activity. The PERFECT scheme  is an acronym with P representing power (or pressure, a measure of strength using a manometric perineometer), E = endurance, R = repetitions, F = fast contractions, and finally ECT = every contraction timed. The scheme has demonstrated reliability and validity as an assessment tool and was developed to simplify and clarify PFM assessment. Urinary incontinence is correlate to pelvic floor muscle dysfunction but its relation with urinary incontinence severity during pregnancy remain unclear. Therefore, the aim of this study was correlate the pregnancy specific urinary incontinence severity with vaginal digital palpation.

This multicenter cross-sectional study was conducted in a tertiary hospital, and was approved by the Research Ethics Committee of the Institution (CAAE: 73305517.5.0000.5411). The mainly inclusions criteria were pregnant women with PSUI, between 18 and 40 years old, primiparous, gestational age between 24 to 30 weeks, normoglycemic and urinary continence prior to the current pregnancy. Personal, anthropometric and clinical data were collected from medical records. For physical examination bladder emptying was requested. Participants were examined in the supine position with their lower limbs flexed with feet on the stretcher, and information about the anatomical position and possible movement of the PFM was obtained to avoid the use of adductor and/or gluteus, hip movements or expulsive movements. To be considered correct the PFM contraction, a vaginal palpation was performed, and a PFM contraction was requested by giving the verbal instruction “squeeze the vaginal muscle and hold as if you were holding urine.Thus, after it functional assessment of the pelvic floor classified by the Perfect scheme were conduct by an expert physiotherapist. At the end ISI questionnaire was applied.

From 376 selected pregnant women, 170 were not included due to diabetes, previous pregnancy or delivery, and/or smoking and 124 were not included because they reported being continents in the current pregnancy. 82 pregnant women who presented PSIU were included for analysis.The average age was 27,9+6,4 years old, the gestational age was 29,5 +5,4 weeks and BMI was 28,2+5,1 kg/cm2. The ISI score was 3,37+1,78 (0-8) and the PERFECT scheme was P=2,7+1,2; E=4+3 seconds; R=3,1+2,7 times and F=6+3,7 times.

Taken together, we concluded that there is no correlation between the vaginal digital palpation by PERFECT scheme with urinary incontinence severity.

This study is currently running, we believe that with the increase of the sample size and the stratification by severity could help us to better understand this data.

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