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Analysis Of Influencing Factors Of Early Maternal Postpartum Pelvic Floor Dysfunction

Posted on:2021-07-27Degree:MasterType:Thesis
Country:ChinaCandidate:Q Y HuangFull Text:PDF
GTID:2504306128970739Subject:Obstetrics and gynecology
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Research Purposes To evaluate the function of early maternal postpartum pelvic floor,and to explore the risk factors of postpartum pelvic floor dysfunction.So as to provide theoretical basis for the prevention and treatment of PFD.Materials and methods The clinical data of 132 parturient women who gave birth in the Second Affiliated Hospital of Fujian Medical University from January 2019 to December 2019 and performed pelvic floor function screening in the Outpatient Department of the hospital 42 days after delivery were analyzed retrospectively.(Inclusion criteria for this study:The subjects were aged from 20 to 42 years,and the gestational age was 37 to 41.143 weeks.All of them were single-birth and pelvic floor function has not been exercised during pregnancy and postpartum.Exclusion criteria:Vaginal bleeding,Surgical history of giant pelvic mass,previous genitourinary infection and other urinary system diseases,long history of chronic cough,constipation and other abdominal hypertension).The subjects were completed 42 days postpartum questionnaire,gynecological examination,pelvic floor ultrasonography and pelvic floor electromyography.Th levator hiatu(LH)area after maximal Valsalva maneuver,mean value of type Ⅰ muscle fibers and maximum value of type Ⅱ muscle fibers were collected by pelvic floor ultrasonography and pelvic floor electromyography,respectively.The data were analyzed with SPSS 22.0 software,the effects of age,parity,gestational age,BPD,delivery mode and prenatal BMI index on pelvic floor function were evaluated by single factor analysis and multi-facto Logistic analysis.Result(1)The rate of type Ⅰ and Ⅱ pelvic floor muscle fiber damage were79.5% and 69.7% respectively.The single factor analysis showed that gestational age(P=0.001)、biparietal diameter(P=0.000)and delivery mode(P=0.000)were related with postpartum type Ⅱ pelvic floor muscle fiber damage,However,there was no correlation with age,parity and prenatal BMI.Multi-factor analysis shoewd that BPD and delivery mode were the risk factors for postpartum type Ⅱ pelvic floor muscle fiber damage.Compared with the parturients with BPD<9.0cm,the parturients with BPD≥9.5cm increased 5.083 times in type Ⅱ pelvic floor muscle fiber damage(95%CI:1.061-24.344).The rate of Ⅱ pelvic floor muscle fiber damage in vaginal delivery was 5.333 times higher than that in Cesarean section(95%CI:2.172-13.092).(2)This study showed that postpartum LH dilation(Lh area > 25cm2)in 34cases(25.8%).The single factor analysis showed that postpartum levator hiatu dilatio were related to age(P=0.000)、delivery mode(P=0.036)and prenatal BMI index,No correlation was found between gestational age,parity,BPD and postpartum LH dilation.Multi-factor analysis shoewd that Age、prenatal BMI index and vaginal delivery were the risk factors for postpartum levator hiatu dilation.Compared with the parturients with age<30 years,the parturients with age30~35 and ≥35years increased 3.280(95%CI:1.207-8.917)and 7.599(95%CI:1.745-33.092)times in postpartum levator hiatu dilation respectively.The rate of postpartum levator hiatu dilation in vaginal delivery was4.574 times higher than that in Cesarean section(95%CI:1.496-11.255).The rate of postpartum LH dilation in parturients with BMI ≥27 was 7.073 times higher than that whose BMI < 24(95% CI: 1.992-25.114).Conclusion(1)The rate of maternal postpartum pelvic floor muscle damage are at a high level,the rate of type Ⅰ and Ⅱ pelvic floor muscle fiber damage were79.5% and 69.7% respectively.(2)The changes of postpartum pelvic floor function were related to age,biparietal diameter,prenatal BMI index and delivery mode.BPD≥9.5cm was the risk factors for postpartum type Ⅱ pelvic floor muscle fiber damage.Age≥35 years and prenatal BMI index≥27kg/m2 were the risk factors for postpartum levator hiatu dilation.Vaginal delivery was the risk factor for postpartum pelvic floor type Ⅱ muscle fiber damage,postpartum LH expansion.In contrast,Cesarean section to a certain extent,the protection of the pelvic floor structure and function.
Keywords/Search Tags:Pelvic floor dysfunction, Levator hiatu, Type Ⅰ muscle fiber, Type Ⅱ muscle fiber
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