Study On The Effect Of Vaginal Delivery On The Pelvic Floor Function Of Primiparas And Its Related Interventions

Objective: Pelvic floor dysfunction has become the most common chronic disease that affects female quality of life.It is of great importance for the prevention and treatment of female pelvic floor dysfunction to systematically research and promote a set of economic and reasonable,practical and effective pelvic floor rehabilitation comprehensive technology.The purpose of our study is to investigate the effect of vaginal delivery on the pelvic floor function of primiparas and its related intervention measures,in order to provide theoretical basis and systematic principle for the prevention and treatment of pelvic floor dysfunction.Methods: Patients who were screened for pelvic floor function in our hospital from March to July,2015 and conformed to the research conditions were chosen for this study,with 100 postpartum primiparas of vaginal delivery in the experimental group and 50 normal non-pregnant women in the control group.6-7 weeks postpartum primiparas of vaginal delivery were investigated by various forms of questionnaire,with normal non-pregnant women as control,to assess the primiparas' general condition,quality of life and psychological state.The pelvic floor functional conditions of post-natal primiparas were detected using the instrument of pelvic floor dysfunction diagnosis and treatment(PHENIXU8): the change of urination function,including the maximal and average urinary flow rate,residual urine volume and micturition reflex;defecation function;defecation reflex;the change of sexual function;sexual reflex;the change of pelvic floor electrical physiological indexes,including pudendal nerve conduction,pelvic floor muscle strength,muscle tone,dynamic pressure,myoelectric potential,pelvic floor muscle tension and pelvic floor dynamics assessment,to diagnose the specific causes of pelvic floor dysfunction for the purpose of targeted and systematic postpartum intervention and treatment.36 cases of puerperae in postpartum anxiety state with pelvic floor dysfunction were divided into two groups randomly for randomized controlled trial.Rehabilitation therapy of pelvic floor muscle was conducted by psychological intervention and PHNIXU8 instrument of pelvic floor dysfunction diagnosis and treatment in the experimental group(20 cases),while rehabilitation therapy of pelvic floor muscle was conducted by common propaganda and education and PHNIXU8 instrument of pelvic floor dysfunction diagnosis and treatment in the control group(16 cases).To discuss the function and influence of psychological intervention and PHNIXU8 pelvic floor dysfunction therapeutic apparatus to the rehabilitation of pelvic floor dysfunction,including stress urinary incontinence,pelvic organ prolapse,sexual dysfunction and anxiety state.Results1.There were significant differences statistically on pelvic organ prolapse,abdominal and pelvic dynamics,sexual function,anxiety and depression between primiparas of vaginal delivery and normal non-pregnant women(P<0.05).2.For the patients in postpartum anxiety state with pelvic floor dysfunction,to assess the effect of treatment at three month postpartum.There were no significant differences statistically on the rehabilitation of pelvic organ prolapse,pelvic floor muscle strength and fatigue and uroclepsia between psychological intervention group and control group(P>0.05),but there were significant differences clinically on the rehabilitation of sexual dysfunction,anxiety and depression state between psychological intervention group and control group(P<0.05).Conclusions:1.It is clear that pregnancy and childbirth affect female pelvic floor function.It has important clinical significance to use a variety of methods to test and evaluate the pelvic floor function of puerperae in the early postpartum period to provide more specific and quantitative diagnosis for the treatment and improvement of pelvic organ prolapse,uroclepsia and sexual dysfunction and the prevention of forward PFD and SUI.2.As an adjuvant therapy,psychological intervention has specific clinical significance in improving the patients' anxiety,sexual dysfunction and so on,but whether or not it is helpful to the recovery of POP and SUI,and its long-term effects need further study.As the diagnosis and treatment levels of every hospital and the targeted people are different,methods for the diagnosis and treatment of postpartum pelvic floor dysfunction are bound to be different.It still needs further exploration by the majority of obstetricians and urologists that how to treat differently and form a standard hierarchical procedure of diagnosis and treatment.