The Status And Influential Factors Of Pelvic Floor Muscle Injury And Its Relationship With Prolapse In Postpartum Women

Pelvic floor muscle refers to the closed muscle group at the bottom of the pelvis.This muscle group is like a "hanging net",the pelvis visceral organs such as the urethra,bladder,vagina,uterus,rectum tightly hanging,Have to maintain pelvic organs in the normal position,to ensure the vaginal tightening,urethral sphincter and rectal sphincter normal function,Once this "net" becomes less flexible,"hanging force" is not enough,it will lead to "network" within the organ can not be maintained in the normal position,resulting in the corresponding dysfunction,such as urinary incontinence,pelvic organ prolapse incontinence and so on.At present,the incidence of pelvic floor muscle injury is about 73.44% or more,but due to pelvic floor muscle injury early postpartum clinical symptoms are not obvious,which is the reason why pelvic floor muscle injury is not valued,if not timely prevention,with age Growth,will develop into pelvic floor dysfunction,which is common to women,spend higher,affecting the quality of life of the disease.Pregnancy and childbirth are the main factors of pelvic floor muscle injury in early postpartum.In midwives,Circumcision and laceration rate is high,This will directly affect pelvic floor muscle function In this study,4037 cases of postpartum pelvic floor screening screening in 6-8 postpartum were statistically analyzed to investigate the status and influencing factors of pelvic floor muscle injury in postpartum women And its relationship with prolapse,And analysis of episiotomy lateral pelvic floor or have an impact,so early detection,early diagnosis and early treatment.ObjectiveIn this study,the detection of pelvic floor electrophysiological indicators,POP-Q,and check the prenatal and postpartum factors to explore postpartum pelvic floor muscle injury and its relationship with prolapse,And analyze the effect of lateralization on pelvic floor function of primiparous women,then regulate and guide pregnant women,For primipara whether side-cut provide the basis,To provide a scientific basis for the prevention and treatment of pelvic floor injury in high-risk pregnant women early postpartum.Materials and methodsSelect 2015.01.01~2016.12.01 for delivery at Henan Maternal and Child Health Hospital,and 4,037 maternal women who underwent pelvic floor muscle screening at 6 to 8 weeks postpartum.The low-frequency neuromuscular stimulation treatment instrument(PHENIXU 8,Guangzhou Shan shan Company)The muscle strength class I and II muscle fibers,class I and II class muscle fiber fatigue ratings,vaginal dynamic pressure values,and pelvic organ prolapse quantification(POP-Q [1])for detecting uterine prolapse The anterior vaginal wall and the posterior vaginal wall bulge,and in the medical record room to investigate the statistics of the mother's age,height and prenatal weight,surgical history,weight gain during pregnancy,pregnancy,parity,gestational age,Delivery methods,fetal weight,fetal head circumference,hypertension,diabetes,Group B Streptococcus(GBS)infection,episiotomy,labor,laceration,oxytocin,painless(ie,epidural anesthesia),etc.generally.SPSS 21.0 statistical software was used to analyze and process the data.The measurement data was analyzed using the T-test and expressed as ±S.The count data were analyzed using the 2 test and expressed as the frequency(rate).Multivariate analysis was performed using Logistic regression analysis.The collinearity of the collinearity diagnosis was used.The coefficient R[2],tolerance,and VIF represent [3,4].The variables were selected based on previous studies and single factor analysis P<0.2.Both tests were performed using two-sided tests with ?=0.05 as the test level.Result1 The abnormal muscular strength of type I was 98.0%(3950/4037);the abnormality of muscular strength of type II was 98.1%(3960/4037);the abnormality of muscular fatigue of type I was 70.0%(2826/4037)The abnormal rate of muscle fatigue was 70.9%(2863/4037);the abnormal rate of dynamic pressure was 88.6%(3577/4037).There was no significant difference between I and II muscle strength and fatigue,p> 0.05;2 There was no significant difference between muscle strength and fatigue of I and II myofibers,p> 0.05;3 The episiotomy was the protective factor of the type I muscle fiber fatigue,p <0.05,but not related to the type II muscle fatigue,the type I muscle strength,the type II muscle strength,the pelvic floor dynamic pressure abnormality and the anterior vaginal wall Bulging,swelling of the posterior vaginal wall,uterine prolapse without correlation p> 0.05;4 Univariate analysis: The abnormal muscular strength of type I myofibers was related to the BMI before pregnancy,mode of delivery,hypertension,GBS infection and weight gain during pregnancy.The muscle strength of type II myofibers was abnormal with age,BMI before pregnancy,mode of delivery,hypertension,GBS Infection and pregnancy weight gain.The factors related to the fatigue of Class I myofibers were mode of delivery,gestational hypertension,head circumference,GBS infection and mother's age.The factors related to the abnormality of Class II muscle fatigue were maternal age,,Parity and pre-pregnancy BMI;factors related to the abnormal dynamic stress were maternal age,mode of delivery,diabetes and pre-pregnancy BMI.The differences were statistically significant,p <0.20;Multivariable logistic regression analysis showed that the muscle strength of type I and II fibers was related to the mode of delivery,head circumference and weight gain before pregnancy.The fatigue of type I myofibers was related to the mode of delivery,head circumference,hypertension,GBS infection and age,In relation to BMI and number of deliveries,the dynamic pressure values were correlated with mode of delivery,weight gain and pre-pregnancy BMI the logistic regression analysis showed that abnormal type I muscle strength was associated with delivery methods,head circumference,gestational weight gain,and pre-pregnancy maternal body mass index(BMI);abnormal type II muscle strength was associated with delivery methods,head circumference,and gestational weight gain;dynamic stress abnormalities related factors was mode of delivery,weight gain during pregnancy,high blood pressure and pre-pregnancy BMI;factors related to type I muscle fatigue were mode of delivery,hypertension,B-positive,fetal head circumference and maternal age;and Class II muscle fatigue abnormalities factors for parity and pre-pregnancy BMI.The differences were statistically significant,p <0.05;5 pelvic floor muscle strength and pelvic floor organ prolapse relationship I,II muscle abnormalities and pelvic floor organ prolapse is positively correlated,p <0.001.Conclusion1 Pregnancy should maintain a normal weight,reasonable control of weight gain during pregnancy,to avoid being too light,at the same time,choose the appropriate mode of delivery;2 Pelvic rehabilitation as early as possible,so that early prevention and early treatment;3 Transverse perineal incision has limited protective effect on pelvic floor muscles.Strict control of lateral incision rate should be used.Indications of use of lateral incision.