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Contraction of the levator ani muscle during Valsalva maneu..:

Kamel, Rasha ; Montaguti, Elisa ; Nicolaides, Kypros H....
American Journal of Obstetrics and Gynecology.  220 (2019)  2 - p. 189.e1-189.e8 , 2019
Link: https://doi.org/10.1016/j.ajog.2018.10.013