The Short-term Effect Of Episiotomy On The Postpartum Pelvic Floor Function

Objectives To explore the short-term effect of episiotomy during delivery on the female pelvic floor function.Methods 267 cases primipara who had routine follow-up 6-8 weeks after delivery at the rehabilitation clinic of Qinhuangdao Maternal and Child Care Service Center between May 2014 and Dec. 2014 were selected. Among them 102 cases who had episiotomy during delivery were chosen as case group, another 165 cases who had no episiotomy were chosen as control group. Recorded the maternal age, the gestational age, the first labor time, the second labor time, newborn birth weight, whether to use painless labor, changes of body weight during pregnancy, lactation way, prevalence of SUI during pregnancy, prevalence of SUI and POP after delivery, postpartum pelvic muscle myodynamia, fatigue, dynamic pressure inside the vagina, perineal pain, anal contraction reflex, centrum tendineum perinei mobility, vaginal opening, wether the ischial spine and ischial tuberosity tenderness of the two groups.Data processing and statistical analysis used SPSS 17.0 statistical analysis package, t-test was used for the measurement data, χ2-test or Fisher-test was used for the counting card information, and there was significantly difference when P<0.05.Results 1 There were no differences btween the two groups in pelvic floor relateing factors(including age, gestational age, the first labor time, the second labor time, newborn birth weight, whether to use painless labor, changes of body weight during pregnancy, lactation way, SUI before delivery)(P>0.05). 2 incidence of SUI: The incidence of SUI after delivery in episiotomy group was 13.7%, was higher than that of control group(6.1%)(χ2=4.527, P<0.05). 3 All of the primipara women suffered from POP in degree Ⅰand degree Ⅱ.There was no differences of prevalence of POP between the episiotomy group and control group(χ2=0.501, P>0.05). 4 Pelvic floor muscles electrophysiology: incidence of injury on myodynamia and fatigue for class Ⅰmuscle fibers in the episiotomy group was 76.5% and 93.1% respectively, which were higher than that in control group(64.8%, 73.5%)(χ2=4.001,5.120, P<0.05). While there waas no difference in myodynamia and fatigue for Class Ⅱ muscle fibers between the episiotomy group and the control group(χ2=1.936,0.128, P>0.05). The abnormal rates of vaginal dynamic pressure in the episiotomy group was 79.4%, which were higher than in control group(61.2%)(χ2=9.621, P<0.05). 5 Pelvic examination: The incidence of perineal pain in the episiotomy group was 12.7% which was higher than that in control group 3.0%(χ2=9.462, P<0.05). The abnormal rates of Vaginal dynamic pressure in the episiotomy group was 79.4% and 19.6%, which were higher than that in control group(7.9%, 8.5%) respectively(χ2=5.861,7.018, P<0.05); The central tendon mobile capacity in the episiotomy group(0.7±0.3) cm was larger than that in control group(0.6±0.2) cm(P<0.05). There were no difference of vaginal opening, ischilal spine and ischilal tuberosity tenderness between the episiotomy group and the control group(P>0.05). Conclusions 1 The effect of episiotomy on SUI was more obvious than natural laceration during delivery; and there was no difference in the incidence of POP of the two groups; 2 Episiotomy injured the myodynamia and fatigue of classⅠmuscle fibers and vaginal dynamic pressure more seriously than natural laceration, but had no obvious protection to class Ⅱ muscle fibes; 3 Episiotomy caused more damage to perineum, nerve reflex and central tendon mobile capacity. 4 Episiotomy had no obvious protection to perineal body and vaginal opening.