| Objective:Application biofeedback therapy apparatus testing early postnatal female pelvic floor muscle fiber strength,explore the effects of the obstetric factors on postpartum early pelvic floor function and the occurrence of pelvic floor dysfunction disease (PFD) and analyze the short-term therapeutic effect of early pelvic floor muscle rehabilitation,as to provide a theoretical basis for early prevention and intervention.Methods:From September2012to December2013,a total of921full-term primipara,who visited the postpartum pelvic floor screening clinics,delivered and had the follow-up at6-10weeks after delivery in Dagang Women and Children Health Care Center of Tianjin Binhai New Area were included.According to the delivery way they were divided into2groups:vaginal delivery group (n=454) and elective cesarean section group(n=467).And primipara whose pelvic floor muscle strength<4or who have symptoms of POP or SUI of100cases were randomly divided into a treated group (n=48) and a control group (n=52).Method is as follows: l.to appraise pelvie floor muscle strength,using biofeedback electrical stimulation Device to gain electromyogram,myoelectricity and defatigation degree of pelvie floor muscle,and adopting vaginal palpation at the same time;2.to compare the effect of different factors of delivery on pelvic floor muscle strength,using questionnaire of pelvie floor dysfunetion,urinary incontinence pads quantitative experiment and pelvic organ prolapse (POP-Q) staging method of score.3.obtain the maternity hospital medical record to statistical analysis obstetric factors.4.to select the puerperas of spontaneous labor and uterine-incision delivery for the treatment of electrical stimulation and vaginal dumbbell training with pelvic muscle exereises;control group is the puerperas who were not treated.Results:l.The normal rate of type Ⅰ and type Ⅱ muscle fiber strength after delivery was62.43%and63.41%; the normal rate of fatigue strength was52.01%and87.19%; the normal rate of pelvic floor pressure was72.96%.There were no significant difference between the different delivery groups (P>0.05).2.The incidence of SUI in pregnancy was21.06%and of ECS group and VD group was respectively19.70%,22.47%.There were no significant difference between the two groups (P>0.05).The incontinence of SUI at6-10weeks after delivery was11.29%and it was8.78%,13.88%, in these two different groups, respectively,with significant difference among them (P<0.05).It showed that the age,vaginal delivery, pregnancy increased BMI,SUI during pregnancy,newborn birth weight the second labor time of vaginal delivery group were risk factors of SUI after delivery.POP-Q Ⅰ and Ⅱ was respectively85.71%and91.67%.The markedly effective rate of patients with POP-Q0-Ⅲ was88.89%.The total effective rate of postpartum SUI was93.75%.Conclusion:1.The relationship between the contractibllity of pelvie floor muscle and PFD close.The result of pelvic floor muscle strength can be used as a good indicatrix to evaluate functional status of pelvie floor muscle.2.Pregnancy and childbirth is an important factor of female pelvic floor functional disorder.3.Delivery way has no effect for the early postpartum pelvic floor muscle strength. Age, BMI, neonatal birth weight, the second labor time and vaginal delivery affect the incidence of the early postpartum period of SUI and POP.4.Pelvic floor muscle rehabilitation therapy for the prevention and treatment of early postpartum pelvic floor functional disorder have curative effect.It can improve the postpartum potential of female pelvic floor muscle strength and vaginal muscles,voltage,and improve the symptoms of POP and SUI after delivery,improve symptoms.which has important clinical significance and should be worthy of promotion. |
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