To Evaluate The Effect Of Different Ways Of Delivery On The Structure And Function Of Pelvic Floor And The Effect Of Rehabilitation Treatment

Objective: Female pelvic floor dysfunction(FPFD)is caused by the defect,damage and dysfunction of the pelvic floor support structure,including incontinence,fecal incontinence,pelvic organ prolapse,and sexual life barrier,which affects the social activities,physical exercise and sexxual life of the patients seriously.So,FPFD is referred as to "social cancer".Pregnancy and delivery is the independent risk factors of FPFD.This study aims to explore the effects of different ways of delivery on the structure and the function of the pelvic floor through the three ultrasound,and evaluate the therapeutic effect of pelvic floor rehabilitation treatment on the patints of stress urinary incontinence(SUI),so as to provide reliable imaging basis for assessing pelvic floor function after production,as well as provide theoretical basis for the treatment of SUI.Methods: The objects of this study were 360 cases of healthy women of childbearing age,which were choosed from the department of gynaecology,obstetrics and reproductive clinic in first affiliated hospital of hebei medical university from April 2015 to September 2015.Among them,the primiparas were divided into two groups according to the different ways of delivery: transvaginal natural delivery group(129 cases)and selective cesarean section delivery group(126cases),and childless women were served as the control group(105 cases).We measured the thickness of bladder detrusor,the angle after bladder,the displacement of bladder neck,the area and perimeter of levator hiatal of 255 cases of primiparas 6 weeks after production by the perineum pelvic floor ultrasound in the state of resting and maximum valsalva.Meanwhile,those indexes of control cases were also measured in the same way.One-way AVONA was used to compare the above indexes among the transvaginal natural delivery group,selective cesarean section delivery group and the control group,so as to determine the effects of the production and different ways of delivery on the structure and function of the female pelvic floor.Meanwhile,75 cases of SUI patients induced by delivery,which were collected from pelvic floor rehabilitation clinic in first affiliated hospital of hebei medical universit,were treated with pelvic floor rehabilitation therapy.Among them,43 cases were induced by the transvaginal natural delivery,32 cases were induced by the selective cesarean section delivery.We measured the thickness of bladder detrusor,the angle after bladder,the displacement of bladder neck,the area and perimeter of levator hiatal of all SUI patients before and after treatment by the perineum pelvic floor ultrasound.Paired samples t test was used to compare the above indexes of SUI patients before and after treatment,aimed to analyze the therapeutic effect of pelvic floor rehabilitation treatment for patients with SUI.Results:1 There are significance differences in the thickness of bladder detrusor,in the angle after bladder,in the displacement of bladder neck,as well as in the area and perimeter of levator hiatal among the transvaginal natural delivery group,selective cesarean section delivery group and the control group(F=271.88,F=546.26,F=455.81,F=265.17,F=237.02,P<0.01).The following Post Hoc multiple comparisons revealed that the above indexes of the transvaginal natural delivery group were higher than those of selective cesarean section delivery group,and which were all higher than those of the control group.2 The total effective rate of pelvic floor rehabilitation treatment for the patients induced by transvaginal natural delivery with was 93.02%.After treatment for six months,the thickness of bladder detrusor,the angle after bladder,the displacement of bladder neck,the area and perimeter of levator hiatal of SUI patients were reduced,there are significance differences in each indexes between before and after treatment(t=9.87,t=12.24,t=8.98,t=8.43,t=7.23,P<0.05).The total effective rate of pelvic floor rehabilitation treatment for the patients induced by selective cesarean section delivery was 93.02%.After treatment for six months,the above indexes of SUI patients were reduced,there are significance differences in each indexes between before and after treatment(t=7.91,t=10.29,t=6.97,t=8.16,t=9.79,P<0.05).Conclusions:1 Pelvic ultrasound can be used to diagnose pelvic floor functional disorder,pregnancy and production can induce different degree of damage on the structure and function of female pelvic floor.Transvaginal natural delivery impacts more serious damage on the structure and function of pelvic floor to the primipara.2 Pelvic floor rehabilitation therapy is effective to the postpartum stress urinary incontinence,pelvic ultrasound can be used to evaluate the therapeutic effect.