The Study On Influence Of Pregnancy And Delivery On The Function Of The Pelvic Floor By Ultrasound Imaging And Pelvic Floor Muscle Strength

Objective1. To evaluate the puerpers' musculus pubococcygeus using perineum three dimensional type-b ultrasonic and pelvic floor myoeletricity physiologic instrument, to research the change of anatomical structure and function of pelvic floor at different times, such as pregnancy, normallabor,selective cesarean section and at the beginning of postpartum, to study the nosogenic relationship between pregnancy, normallabor,selective and pelvic floor dysfunctional illness.2. To compare the changes of musculus pubococcygeus at pregnancy,and at the beginning of postpartum using different delivery modes, to provide clinic references for preventing pelvic floor dysfunctional illness.Research Method1. Detect the thickness, line feed, direction and interior echo of musculus pubococcygeus under rest status and Valsalva status using perineum three dimensional type-b ultrasonic.2. Evaluate the muscle force and muscle tension of type I, II pelvic floor muscle fiber and dynamic pressure of pelvic floor.Method1. Select 50 primiparity pregnant women at the age of 20-35 years old with gestation period of 28-36 weeks at random as the research subjects to collect the clinic medical history2. Adopt 3DUS probe to detect the selected cases' musculus pubococcygeus' thickness, line feed, direction and interior echo under the rest status and Valsalva status at the gestation period of 28-36 weeks.3. Divide the selected cases into normal vaginal delivery group, nonselective cesarean section group and selective cesarean section group, and then re-test the above mentioned datas 6-8 weeks and 12-14 weeks post partum, respectively.4. Process questionnaire survey through using International Consultation on Ineontinenee Questionnaire Female Lower Urinary Traet Symptoms Module, ICIQ一FLUTS), record the urinary incontinence situation,and grade the cavum pelvis organ procidentia and the detect the pelvic floor electromyogram.5. Set another control group with 20 health un-pregenant women to detect the above mentioned indices.Results:1. There are 149 primiparity pregnant women meet the requirements and are brought into research,including 89 normal vaginal delivery and 59 selective cesarean section.The follow-up survey rate after delivery for 6-8 weeks is 100%, the follow-up survey rate for 135 cases after 12-14 weeks of the delivery is 71.4%.2. It can clearly demonstrate the anatomical structure of pelvic floor using perineum three dimensional ultrasonic examination. There are significant differences compare with the control group at the third trimester of pregnancy, the differences possess statistics significance ( P<0.05).There are evident changes between the vaginal delivery group and selective group at 6-8 weeks after the delivery, the difference possess statistics significance ( p<0.05).There is no evident difference at 14-14 weeks after delivery between two groups.3. Diagnose and evaluate the 149 cases' pelvic floor myoeletricity physiology, there are significant differences compare with the control group at the third trimester of pregnancy, the differences possess statistics significance ( P<0.05).There are evident changes between the vaginal delivery group and selective cesarean section group at 6-8 weeks after the delivery, the difference possess statistics significance ( p<0.05).There is no evident difference at 12-14 weeks after delivery between two groups.Conclusions1. By ultrasound imaging:Adopting perineal three dimensional ultrasound to observe the figure changes of musculus pubococcygeus after the pregnancy, normallabor and selective cesarean section , musculus pubococcygeus can thinner and contraction degree is weak.2. By ultrasound imaging: The musculus pubococcygeus are no significant different between normallabor and selective cesarean section at postpartum three months3. By evaluation pelvic floor myoeletricity physiology, Evaluating the muscle (levator ani muscle ) force of type I, II pelvic floor muscle fiber after pregnancy and delivery and dynamic pressure of pelvic floor are weaker while estimating the change of pelvic floor's muscle function.4. By evaluation pelvic floor myoeletricity physiology, Evaluating the muscle (levator ani muscle ) force of type I, II pelvic floor muscle fiber after pregnancy and delivery and dynamic pressure of pelvic floor are no significant different5. By evaluation pelvic floor myoeletricity physiology, Evaluating the muscle (levator ani muscle ) force are no significant different between the vaginal delivery group and selective cesarean section group.