CClinicalTrials.gg
CompletedNCT05654324Updated Nov 2, 2023

The Effect of Pelvic Floor Muscle Exercises on the Inferior Vena Cava

An interventional study of pelvic floor muscle exercises in Supine Hypotensive Syndrome, sponsored by Izmir University of Economics. Completed at 1 site in Turkey. Open to female participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-11-02.

Sponsored by Izmir University of Economics · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
51
Allocation
Non-randomized
Ages
18 Years to 40 Years
Sex
Female
01

Study summary

The aim of this study is to examine the effect of pelvic floor muscle exercises on the hemodynamic responses of the vena cava inferior in pregnant and non-pregnant women.

Read the detailed description

The IVC is responsible for approximately two-thirds of the total venous return to the heart. The blood flow in the IVC is affected by the respiratory and cardiac cycle. One of the factors affecting blood flow is pregnancy. Studies have shown that the hemodynamic responses of the IVC may vary depending on the position, and that the supine position puts pressure on the IVC during pregnancy.

Compression of the growing fetus against the IVC can cause supine hypotensive syndrome and fetal danger. However, there is no definite finding about the effects of exercise performed in the supine position. Jefferys et al. reported that the reduction in blood flow at rest is twice that that occurs during exercise and that the level of blood flow should not be a cause for concern in healthy asymptomatic women who choose to exercise in the supine position in late pregnancy. Based on this information, we predict that pelvic floor muscle exercises can change the hemodynamic responses of the IVC and reduce the compression on it.

In order to evaluate the effect of pelvic floor muscle exercises on hemodynamic responses of IVC and compression on it, pregnant and non-pregnant women will be measured by ultrasonography. Women eligible for the study will be seated and rested for 30 minutes before taking the measurement. Then, he will be taken to the supine position, rested for 2 minutes, and the first measurements will be taken at the 3rd minute. pelvic floor muscle exercises will be applied for 5 minutes as stated in the literature. Ultrasonographic measurements will be repeated in the supine position immediately after the pelvic floor exercises and 5 minutes after the exercise. Measurements will be applied to all participants in the same order. During the exercises blood pressure, heart rate and peripheral oxygen saturation will be monitored. Before and after the exercises, the heart rate and blood pressure parameters of the women will be recorded.

02

Conditions studied

  • Supine Hypotensive Syndrome
03

In context

Lead sponsor

Izmir University of Economics is the lead sponsor of 20 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

Experimental group

  • Being pregnant between the ages of 18-40,
  • At least primary school graduate and able to read and write,
  • The gestational age is 20-40 weeks,
  • Not having any mental problems that prevent cooperation and understanding.

Control group

  • Being a non-pregnant woman who is in the same age range as the experimental group,
  • At least primary school graduate and able to read and write,
  • Not having any mental problems that prevent cooperation and understanding.

Exclusion criteria

Exclusion Criteria:

  • Pregnant women with acute or chronic diseases with poor placental adaptation and vascular damage such as diabetes, chronic arterial hypertension and preeclampsia, as the fetus is closer to the threshold of hypoxia and acidemia and adaptive phenomena may fail,
  • Pregnant women with intra-uterine growth restriction and fetal anomaly,
  • Pregnant women with cardiovascular disease,
  • Pregnant women considered as high risk by the obstetrician,
  • Pregnant women with premature, premature birth or miscarriage risk,
  • Pregnant women diagnosed with neurological disease,
  • Obese women (body mass index > 30),
  • Women whose IVC measurements cannot be made with ultrasonography,
  • Women with severe low back pain (not able to do housework regularly),
  • Women who have been diagnosed with a psychiatric illness,
  • Women with a history of gynecological surgery,
  • Women with pelvic floor dysfunction,
  • Women who cannot lie in the supine position.
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
51 participants (actual)

Study arms

  • Experimental
    Pregnant women

    Pregnant women aged 18-40, 20-40 weeks of gestation.

    Other: pelvic floor muscle exercises

  • Active comparator
    Non-Pregnant

    Being a non-pregnant woman who is in the same age range as the experimental group.

    Other: pelvic floor muscle exercises

Interventions

  • Otherpelvic floor muscle exercises

    Before the pelvic floor exercises are taught to all women participating in the study, a brief informational training about the function and structure of the pelvic floor and pelvis will be given using visuals. The application protocol will be given by experienced specialist physiotherapists who have received special training on pelvic floor muscle training. In this study, the training protocol described by Mørkved et al and Bø et al will be used. An exercise series will consist of slow and fast muscle contractions of the pelvic floor muscles. The exercise series will include 10 reps of maximum pelvic floor muscle contraction held for 6 seconds followed by three rapid muscle contractions. A 10-second rest period will be given between each exercise series. A total of 5 minutes, 4 repetitions of pelvic floor muscle contraction series will be applied, including the rest period.

06

What researchers measure

Primary outcomes

  1. Change of the collapsibility index (%) of IVC

    The collapsibility index (%) of IVC will be calculated using the formula: \[(Maximum IVC diameter - Minimum IVC diameter)/Maximum IVC diameter\] × 100.

    Time frame: immediately after the intervention

  2. Change of Pulsatility index of IVC

    Doppler (Toshiba Medical Systems, Aplio 400, Berlin) flow velocimetry will be evaluated.

    Time frame: immediately after the intervention

  3. Changes of IVC diameters

    M mode ultrasonography will be used for expiratory (IVC d min) and end-inspiratory (IVC d min) diameter measurement.

    Time frame: immediately after the intervention

Secondary outcomes

  1. Change of the collapsibility index (%) of IVC

    The collapsibility index (%) of IVC will be calculated using the formula: \[(Maximum IVC diameter - Minimum IVC diameter)/Maximum IVC diameter\] × 100.

    Time frame: 5 minutes after the intervention

  2. Change of Pulsatility index of IVC

    Doppler (Toshiba Medical Systems, Aplio 400, Berlin) flow velocimetry will be evaluated.

    Time frame: 5 minutes after the intervention

  3. Changes of IVC diameters

    M mode ultrasonography will be used for expiratory (IVC d min) and end-inspiratory (IVC d min) diameter measurement.

    Time frame: 5 minutes after the intervention

07

Study locations

1 site
  • Health Sciences University İzmir Tepecik Education and Research Hospital Gynecology and Obstetrics Clinic
    İzmir, Turkey
08

References and documents

Publications

  • Klein-Weigel PF, Elitok S, Ruttloff A, Reinhold S, Nielitz J, Steindl J, Lutfi P, Rehmenklau-Bremer L, Hillner B, Fuchs H, Wrase C, Herold T, Beyer L. Inferior vena cava-syndrome. Vasa. 2021 Jul;50(4):250-264. doi: 10.1024/0301-1526/a000919. Epub 2021 Jan 18. PubMed 33459041 ↗
  • Gagne MP, Richebe P, Loubert C, Drolet P, Gobert Q, Denault A, Zaphiratos V. Ultrasound evaluation of inferior vena cava compression in tilted and supine term parturients. Can J Anaesth. 2021 Oct;68(10):1507-1513. doi: 10.1007/s12630-021-02051-w. Epub 2021 Jul 1. PubMed 34212308 ↗
  • Fields JM, Catallo K, Au AK, Rotte M, Leventhal D, Weiner S, Ku BS. Resuscitation of the pregnant patient: What is the effect of patient positioning on inferior vena cava diameter? Resuscitation. 2013 Mar;84(3):304-8. doi: 10.1016/j.resuscitation.2012.11.011. Epub 2012 Nov 21. PubMed 23178869 ↗
  • Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available. PubMed 26580836 ↗
  • Supine lying during pregnancy. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy. 2018; 122:77-83
  • Jeffreys RM, Stepanchak W, Lopez B, Hardis J, Clapp JF 3rd. Uterine blood flow during supine rest and exercise after 28 weeks of gestation. BJOG. 2006 Nov;113(11):1239-47. doi: 10.1111/j.1471-0528.2006.01056.x. Epub 2006 Sep 15. PubMed 16978230 ↗
  • Kim DR, Wang E. Prevention of supine hypotensive syndrome in pregnant women treated with transcranial magnetic stimulation. Psychiatry Res. 2014 Aug 15;218(1-2):247-8. doi: 10.1016/j.psychres.2014.04.001. Epub 2014 Apr 12. PubMed 24768354 ↗
  • Finnerty NM, Panchal AR, Boulger C, Vira A, Bischof JJ, Amick C, Way DP, Bahner DP. Inferior Vena Cava Measurement with Ultrasound: What Is the Best View and Best Mode? West J Emerg Med. 2017 Apr;18(3):496-501. doi: 10.5811/westjem.2016.12.32489. Epub 2017 Feb 24. PubMed 28435502 ↗
  • Shailja S, Gupta I, Suri V. Inferior vena cava diameters in pregnant women for prediction of pregnancy-induced hypertension. Int J Gynaecol Obstet. 2004 Feb;84(2):164-5. doi: 10.1016/S0020-7292(03)00157-7. No abstract available. PubMed 14871520 ↗
  • Singh Y, Anand RK, Gupta S, Chowdhury SR, Maitra S, Baidya DK, Singh AK. Role of IVC collapsibility index to predict post spinal hypotension in pregnant women undergoing caesarean section. An observational trial. Saudi J Anaesth. 2019 Oct-Dec;13(4):312-317. doi: 10.4103/sja.SJA_27_19. PubMed 31572075 ↗
  • Dodhy AA. Inferior Vena Cava Collapsibility Index and Central Venous Pressure for Fluid Assessment in the Critically Ill Patient. J Coll Physicians Surg Pak. 2021 Nov;31(11):1273-1277. doi: 10.29271/jcpsp.2021.11.1273. PubMed 34689482 ↗
  • Morkved S, Bo K, Schei B, Salvesen KA. Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial. Obstet Gynecol. 2003 Feb;101(2):313-9. doi: 10.1016/s0029-7844(02)02711-4. PubMed 12576255 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 2, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05654324
Lead sponsor
Izmir University of Economics
Responsible party
Seda Yakit Yesilyurt (Lecturer Dr, Izmir University of Economics) — Principal investigator
First posted
Dec 16, 2022
Start date
May 1, 2023
Primary completion
Oct 1, 2023
Completion
Oct 2, 2023
Last update
Nov 2, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion