Feasibility Study Of Shear-wave Elastography On Elastic Changes Of Levator Ani Muscle In Primiparas

Objective: Shear Wave Elastography（SWE）was applied to examine the Puborectalis muscle（PR）after the first delivery.The elastic modulus of PR was measured at rest and the difference of contraction was calculated when the anal contraction was completed.The elasticity and contractility of levator ani muscle were compared between the group with and without pelvic organ prolapse.The group with pelvic organ prolapse was followed up to explore whether pelvic floor muscle rehabilitation training can improve the elasticity of levator ani muscle.Methods: Women who delivered in our hospital from September2020 to August 2021 and were examined 42 d after delivery with newborn weight between 2800 and 3800 g were collected.According to routine pelvic floor ultrasound examination,60 cases with pelvic organ prolapse and 20 cases without pelvic organ prolapse were included,a total of 80 cases.At the same time,30 childless married women with no abnormality in pre-pregnancy physical examination were selected in our hospital during this period.Patients with pelvic organ prolapse were followed up and divided into two groups according to whether a full cycle of regular and systematic pelvic floor muscle rehabilitation training was performed:the pelvic floor muscle rehabilitation training group（n=35）and the group without pelvic floor muscle rehabilitation training（n=25）.SWE technique was used to measure the elastic modulus of PR on the left and right sides,and record the difference between retraction anal state and resting state.Results: 1.Postpartum 42 d,pelvic organ prolapse,pelvic organ prolapse group and the control group between left and right side of the PR in the resting state,shrinking anus state of elastic modulus value comparison,the difference had statistical significance（P < 0.05）,and the comparison between the three groups of left and right side PR shrinkage anal state and resting state difference,the difference had statistical significance（P < 0.05）.2.Postpartum 100 d,there were statistically significant differences in the elastic modulus values of left and right side PR resting state and anal contraction state between the pelvic floor muscle rehabilitation training group and the group without pelvic floor muscle rehabilitation training（P < 0.05）,and there were statistically significant differences in the difference values of left and right side PR anal contraction state and anal contraction state between the two groups（P < 0.05）.Conclusion: 1.The elasticity and contractile function of levator ani muscle in postnatal women were worse than those in non-fertile women,and it was more significant in those with pelvic organ prolapse than those without.2.Postpartum pelvic floor muscle rehabilitation training is conducive to the recovery of the flexibility and contraction of levator ani muscle.3.SWE can be used as a new technique to evaluate the efficacy of pelvic floor muscle rehabilitation training.