| Objectives By analyzing the incidence of stress urinary incontinence in full-term pregnancy and relevant ultrasonic measurement of pelvic floor structure in full-term pregnancy, we can understand the influent factors so that to explore the clinicle significance of diagnosis and assessment in stress urinary incontinence disease with the perineal ultrasound-assisted application.Methods 176 women are collected in the maternity ward in Hebei United University affiliated hospital from Dec 2012 to Dec 2013. They are all asked to fill in ICI-Q-SF questionnaire, including circumstance, time, frequency and the impact of the urinary incontinence. According to the dividing diagnostic criteria of ICI-Q-SF, 92 late pregnancy patients were diagnosed of stress urinary incontinence and the other 84 were treated as matched control. We also get their the medical history, and do gynecological examination, and trans-perineal ultrasound measurements of relevant variables for them. Then the ultrasound image morphology are analyzed; the two groups are comparable in age, weight, production time and delivery mode. We analyze the ultrasound results of the two groups and make a preliminary discussion in ultrasound diagnosis in stress urinary incontinence of the full-term pregnancy.Results 1 The comparison results of the general situation between two groups. 1) The multipara and SUI incidence are closely related, the risk of maternal is 6.12 times than that of the women of first pregnancy, the difference is statistically significant(P<0.05); 2) The body mass index before pregnancy is related to the SUI incidence, the risk of SUI increased with the increase of BMI before pregnancy, the difference is statistically significant(P<0.05); 3) The SUI incidence is related to the fetal weight closely, the risk of the women of the fetal weight ≥4000g is 3.46 times than that of the women of the fetal weight <3500g, the difference is statistically significant(P<0.05). 2 The comparison results of ultrasonic between two groups. 1) The mobile degree of urethrovesical junction(UVJ-M) of SUI group is significant increased compared with the control group(P<0.01) in stress phase and in anal shrinkage phase; 2) The poster urethrovesical angel of SUI group is lager than them of control group in resting, stress and shrinkage anal phase(P<0.01); 3) The urethra inner diameter of SUI group is smaller them of control group in resting, stress and anal shrinkage phase, which is all significant(P<0.05). 4) The distance of urethrovesicaljunction and pubic symphysis midpoint is significantly smaller of SUI group than them of control group in shrinkage phase, which is statistically significant in anal shrinkage phase(P<0.01). 5) The logistic results indicates the increased UVJ-M 1, β2, UVJ-M 2 and decreased DU1 all can increase the risks of SUI. 6) If we regard the poster urethrovesical angel in stress phase β2>135°as a diagnostic threshold for stress urinary incontinence, the sensitivity is 73.9%, specificity is 85.7%; If we regard the mobile degree of urethrovesical junction(UVJ-M) in stress phase UVJ-M1>3.95 mm as a diagnostic threshold for stress urinary incontinence, the sensitivity is 93.5%, specificity is 64.3%. If we regard the poster urethrovesical angel in stress phase β2>135° and the mobile degree of urethrovesical junction(UVJ-M) in stress phase UVJ-M1>3.95 mm as a diagnostic threshold for stress urinary incontinence, the sensitivity is 69.6%, specificity is 95.2%. If we regard the poster urethrovesical angel in stress phase β2>135° or the mobile degree of urethrovesical junction(UVJ-M) in stress phase UVJ-M1>3.95 mm as a diagnostic threshold for stress urinary incontinence, the sensitivity is 97.8%, specificity is 60.7%.Conclusions 1. The risk factors for full-term pregnancy women to suffer SUI are the history vaginal delivery, the increased fetal weight and the higher BMI before pregnancy, the increased UVJ-M 1, β2, UVJ-M 2 and decreased DU1; 2. Ultrasound displays the UVJM over 3.95 mm in stress phase, or the poster urethrovesical angel in stress phase over 135°can be used as diagnostic criteria of full-term pregnancy SUI. Ultrasound displays if UVJ-M1≥3.95 mm and β2≥135°can be used as diagnostic criteria, it will improve the diagnostic value. |
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