Analysis And Research On Clinical Data Of Female Stress Urinary Incontinence In 42 Days Postpartum

Objective:To analyze the high risk factors of female stress urinary incontinence in 42 days postpartum,and to explore the diagnostic value of pelvic floor three-dimensional ultrasound in 42-day postpartum female stress urinary incontinence,and provide scientific evidence for the prevention and treatment of stress urinary incontinence.Methods:500 cases of maternal postpartum examinations were performed in January2017 Dalian Maternal and Child Health Hospital Female Pelvic Floor Rehabilitation Center.500 cases of general maternal data were recorded,including mode of delivery,maternal birth,age,neonatal weight,constipation history,BMI,or lateral perineotomy,second stage of labor,postpartum urinary retention,urinary incontinence during pregnancy,vaginal anterior wall bulging,etc.,to find out the postpartum puerperium stress urinary incontinence related factors analysis and analysis.Randomly selected 30 cases of non-urinary incontinence,24 cases of urinary incontinence during pregnancy,38 cases of postpartum urinary incontinence,3D ultrasound examination of pelvic floor,and recorded ultrasound results,including urethral angle(rest,Valsalva action),The rotation angle of the urethra,the length of the urethra,the degree of bladder neck movement,the position of the bladder neck under Valsalva action,the area of the levator ani muscle,and the formation rate of the urethral funnel were compared.The results of the three-dimensional ultrasound series of the pelvic floor were compared and the results were statistically analyzed.Results:1.Of the 500 maternal women who were reviewed 42-60 days postpartum,49 had postpartum stress urinary incontinence for 42 days,the incidence rate was 9.8%;the incidence of stress urinary incontinence during pregnancy was 10.2%;2.Analysis of factors related to postpartum stress urinary incontinence found that vaginal delivery,delivery times ? 2 times,constipation history,lateral perineotomy,vaginal anterior wall bulging was significantly associated with stress urinary incontinence,(P <0.05),neonatal weight,maternal age There was no significant correlation between the number of pregnancies,BMI,second stage of labor,stress urinary incontinence during pregnancy and postpartum stress urinary incontinence(P>0.05);3.Three-dimensional ultrasound results of pelvic floor: postpartum stress urinary incontinence group at rest period urethral tilt angle,urethral rotation angle,bladder neck mobility,levator ani muscle hole area were significantly increased compared with postpartum stress urinary incontinence group(P<0.05)The position of the bladder neck under Valsalva was significantly lower than that in the non-stress urinary incontinence group(P<0.05).The urethral tilt angle,urethral rotation angle,bladder neck movement,Valsalva action,bladder neck position and angina in the stress urinary incontinence group during pregnancy There was no significant difference between the area of ??myotomy and the postpartum stress urinary incontinence group(P>0.05).The urinary tract inclination angle>51 ° at rest was the accuracy of diagnosis of stress urinary incontinence and the accuracy was 69.1%,and the sensitivity was 2.6%.Specificity100%;urinary tract rotation angle>92.5 ° for the diagnosis of stress urinary incontinence threshold accuracy 66%,sensitivity 23.7%,specificity 96.7%;bladder neck mobility >46mm for the diagnosis of stress urinary incontinence threshold Accuracy 72.5%,sensitivity 7.9%,specificity 100%;diagnosis of stress urinary incontinence with a levator ani muscle hole area >36.5cm2 as the critical value of67.8%,sensitivity 2.6%,specificity 100%;Valsalva action Lower bladder neck position is less than shame 16 mm on the bone joint horizontal line is the critical value for the diagnosis of stress urinary incontinence,with an accuracy of 27.1% and a specificity of100%.The urethral funnel formation rate in the urinary incontinence group and postpartum stress urinary incontinence group was higher than that in the postpartum stress urinary incontinence group(P<0.05).Conclusion:1.Vaginal delivery,delivery times?2 times,perineal side cut,constipation history can increase the risk of postpartum stress urinary incontinence,vaginal anterior wall bulging is positively correlated with postpartum stress urinary incontinence.2.Three-dimensional ultrasound under the vaginal pelvic floor: the urethral tilt angle,the urethral rotation angle,the bladder neck movement,the levator ani muscle area,the bladder neck position under Valsalva action,and the urethral funnel formation can be used as stress assessment Reference index for urinary incontinence.