Correlation Between Different Delivery Modes And Postpartum Pelvic Floor Dysfunction

Objective:To explore the correlation of different delivery way with dysfunction of postpartum basin, for pelvic floor functional disorder provide beneficial reference for the establishment of prevention measures.Methods:January2012-August2013in Jinan Maternity And Child Care Hospital childbirt, and met the inclusion and exclusion criteria for the study of248cases of maternal object, according to the mode of delivery for all mothers will be divided into different groups elective cesarean section and vaginal delivery group. Were observed maternal pelvic organ prolapse and stress urinary incontinence occurrence, and pelvic floor muscle tension and pelvic floor EMG was measured.Results:(1) Before delivery, the rate was28.13%vaginal delivery group stress urinary incontinence, the occurrence of stress urinary incontinence elective cesarean section group rate of27.63%, the difference was obvious, was not statistically significant (P>0.05). After delivery, vaginal delivery group stress urinary incontinence was12.5%, the occurrence of stress urinary incontinence elective cesarean section group rate of4.61%, the difference was significant, with statistical significance (P<0.05).(2) The occurrence of vaginal delivery group anterior vaginal wall prolapse033cases (34.38%), grade Ⅰ52cases (54.18%), grade Ⅱ11cases (11.46%); elective cesarean section group had anterior vaginal wall off vertical097cases (63.81%), grade Ⅰ cases (29.61%), grade Ⅱ10cases (6.58%), the difference was significant, with statistical significance (P<0.05). Vaginal delivery group had vaginal wall prolapse023cases (23.96%), grade Ⅰ69cases (71.88%), grade Ⅱ4cases (4.16%); elective cesarean section group had vaginal wall prolapse0115cases (75.66%), grade I37cases (24.34%), grade II0patients (0%), the difference was significant, with statistical significance (P<0.05). Vaginal delivery group had uterine prolapse grade062cases (64.58%), grade I34cases (35.42%), grade II0patients (0%); elective cesarean section group had uterine prolapse grade0127cases (83.55%), grade I25cases (16.45%), grade II0patients (0%), the difference was significant, with statistical significance (P<0.05).(3) Vaginal delivery group at6weeks postpartum mothers, three months, six months of muscle tension scores were3.18±1.07,3.67±1.14,4.01±1.20; selective cesarean group of mothers in the postpartum6weeks,3months,6months muscle tension scores were3.89±1.21,4.13±1.29,4.35±1.32. Two of six weeks postpartum, muscle tension scores between3months is significant, statistically significant (P<0.05);6months, no significant difference in muscle tone score, no statistically significant (P>0.05).(4) Deep pelvic floor muscle vaginal delivery group grade0-Ⅱ31cases, grade Ⅲ-V65cases, damage rate of32.29%; elective cesarean section group deep pelvic floor muscle strength grade0～Ⅱ44cases, grade Ⅲ～Ⅴ108cases, damage rate of28.95%, the difference was obvious, was not statistically significant (P>0.05). Vaginal delivery group pelvic floor muscle strength grade0～Ⅱ shallow50cases, grade0～Ⅲ46cases, damage rate of52.08%; elective cesarean section group deep pelvic floor muscle strength grade0～Ⅱ73cases, grade Ⅲ-Ⅴ79cases, damage rate of48.03%, the difference was obvious, was not statistically significant (P>0.05).(5) Energy value vaginal delivery group were:Left14.6±1.1, right side12.7±0.9, difference2.0±1.1, mean25±4; energy value elective cesarean section group were:Left16.4±1.5, the right of17.4±1.7, difference-1.4±0.6, mean30±5, the difference was significant, with statistical significance (P<0.05). Peak vaginal delivery group were: Left21.9±1.3, the right side of18.6±1.2, difference3.6±0.6, mean30±6; energy value elective cesarean section group were:Left21.4±1.8, right side21.0±1.5, difference1.4±0.5, mean33±4, the difference was obvious, with statistical significance (P>0.05). Vaginal delivery group velocity values were as follows:the left20.5±1.8, right side16.4±1.5, difference-4.3±1.2, mean19±3; energy value elective cesarean section group were:Left18.6±2.4right18.3±2.2, difference0.4±0.1, mean20±4, no significant difference between the two groups, with statistical significance (P>0.05). Energy value vaginal delivery group were:Left73±7, right side96±12, the difference between1.3±0.5, mean78±6; function valueselective cesarean section group were:Left97±15, the right of17.4±1.7, difference-1.4±0.6, mean110±17, the difference was significant, with statistical significance (P <0.05).Conclusions:(1) Elective cesarean section can be reduced to some extent, stress urinary incontinence and anterior vaginal wall prolapse, vaginal wall prolapse, uterine prolapse occurs, reduce risk, but you can’t avoid all.(2) Early pelvic floor function after elective cesarean section was significantly better than the vaginal delivery group, but the function of the pelvic floor and there is no protective effect of long-term recovery, and the pelvic floor muscle damage and there is no direct correlation between the mode of delivery.(4) As we old, hormone levels ddown, pelvic floor dysfunction, pelvic floor dysfunction disease prevalence rises,we recommend early postpartum pelvic floor muscle exercises to restore pelvic floor function and long-term recommendations postpartum pelvic floor muscle to consolidate the pelvic floor function.