Study On The Ultrasonic Imaging Differences And Clinical Significance Of Pelvic Floor Organization Between Pregnancy And Different Delivery Mode

ObjectivesPelvic ultrasound is applied to display the pelvic viscera and structure, observe the effect of pregnancy, vaginal delivery and selective caesarean section on the anatomical structure of the pelvic floor. To investigate the correlation between the pelvic anatomical structural changes and the pelvic floor dysfunction for early diagnosis and prevention.MethodsAll the selected cases are from the outpatients and inpatients at Xinxiang Central Hospital gynecology from 2014 January to 2015 January. Obtaining informed consent from the patients, a total of 220 cases are randomly selected and divided as follows:65 cases in the Control Group (women without children),72 cases in Case Group 1 (women with spontaneous vaginal delivery), and 83 cases in Case Group 2 (women with the cesarean section operation). For the control group, observing the anterior pelvic floor face midsagittal images both in its resting state and the maximal Valsalva action by using two-dimensional ultrasound; For Case Group 1 and Case Group 2, observing the anterior pelvic floor face midsagittal images both in its resting state and the maximal Valsalva action by using two-dimensional ultrasound at 32-40 weeks of pregnancy, childbirth after 6～8 weeks and 12～14 weeks respectively. To be observed are bladder outlet, bladder neck distance from the lower edge of pubic symphysis distance (BSD), posterior urethra vesical angle (β), bladder neck descent distance (BND), and angle after the bladder wall and standing vertical lines (γ) etc.. For the control group, observing the changes of anteroposterior diameter, transverse diameter and area of Levator hiatus both in its resting state and the maximal Valsalva action by using three-dimensional ultrasound; For Case Group 1 and Case Group 2, observing the changes of anteroposterior diameter, transverse diameter and area of Levator hiatus both in its resting state and the maximal Valsalva action by using three-dimensional ultrasound at 32～40 weeks of pregnancy, childbirth after 6～8 weeks and 12～14 weeks respectively. The statistical analysis are carried for observed data. Statistical analysis of the pelvic floor dysfunction after delivery occurred in Case Group 1 and Case Group 2.ResultsThe incidence of stress urinary incontinence (stress urinary incontinence, SUI) is 0 cases (0%) for the control group, for Case Group 1 and Case Group 2 the incidence of SUI after childbirth 6 to 8 weeks is 21 (29.17%) cases and 5 (6.02%) cases respectively; for for Case Group 1 and Case Group 2 the incidence of SUI after childbirth 12 to 14 weeks is 15 (20.83%) and 3 (3.61%) cases respectively, There is statistical significance (P< 0.05) for Case Group 1 and Case Group 2. There is no occurrence of pelvic organ prolapse (POP) in the three groups. In the resting state, there is no statistical significance between the related data differences acquired by two-dimensional ultrasound. In maximal Valsalva action, there is statistical significance of BND and y between the three groups:BND of the two case groups are higher than those of the control group, and y is lower. There is statistical significance of BND and y between the two case groups:BND of Case Group 1 is higher than those of Case Group 2. y of Case Group 1 is lower than those of Case Group 2. In the resting state and the maximal Valsalva action, there is statistical significance in the same group with the measured data of levator Hiatus:the data in the maximum Valsalva action are higher than those in resting state those in the resting state. Under the same condition, the measured data of Case Group 1 are higher than those of Case Group 2 which are higher than those of the control group.Conclusion1. The anatomy and function of the pelvic floor changes caused by pregnancy and postpartum stress urinary incontinence correlation, natural vaginal delivery has significantly higher impact than the elective cesarean section on the pelvic floor.2. Ultrasound imaging of the pelvic floor structures can provide the guidance for early diagnosis and prevention of pelvic floor dysfunction.