| Objective:Collected the basic cases of maternal women 6 weeks and used the perineal ultrasound to observe the structure of female pelvic floor after 6 weeks postpartum to evaluate the early pelvic floor function of the maternal postpartum and to understand the changes in the structure and function of the pelvic floor.Analyze postpartum influencing factors of early pelvic floor function in order to give some advice on prevention strategies and measures for pelvic floor dysfunction diseases and promote the physical and mental health of women who have been educated and provide a scientific basis for improving the quality of life of women.Methods:Six weeks after delivery from July 2016 to December 2016 in a hospital in Shenyang,women who were born after delivery and those who were pregnant before pregnancy were selected as subjects.Detected the pelvic floor related indicators by ultrasound and assessed maternal postpartum pelvic floor function to diagnose pelvic floor dysfunction.Collected the general information of the research subjects,the delivery situation and the newborn data by designing the questionnaire.The database was built by Excel 2010 software and statistical analysis was performed by IBM SPSS 24.0 software.The normal data were tested by t test;the count data were analyzed by chi-square test and the factors affecting pelvic floor function were analyzed by multivariate logistic regression.Test level sets to?=0.05.Results:1.271 women with postpartum 6 weeks of perineal ultrasonography were performed in a hospital in Shenyang from July 2016 to December 2016.Among them,the youngest was 21 years old and the oldest was 45 years old and the average age was(29.67±3.05)years old;the average prenatal BMI index was(28.05±3.49);the average newborn weight was(3.68±0.43)kg and the average neonatal biparietal diameter was(9.47±0.33)cm.2.Perineal ultrasound was used to evaluate maternal pelvic floor function.The minimum bladder neck down distance of 271 cases was 0.44cm,the maximum bladder neck down distance was 5.98cm,and the average measured value was(2.85±1.00)cm.The minimum bladder neck rotation angle was 2.20°,the maximum bladder neck rotation angle was 126.62°,the average measurement value was(65.05±28.08)°.The minimum retro vesical angle was 93.92°,the maximum retro vesical angle was 212.13°,and the average measurement was(160.14±20.39)°.The minimum levator hiatal area was 8.12 cm~2,the maximum levator hiatal area was 40.68 cm~2,and the average area was(21.14±5.59)cm~2.3.The abnormal rate of bladder neck down distance in vaginal delivery group and cesarean section group was 79.23%and 35.94%.The abnormal rate of bladder neck rotation angle in vaginal delivery group and cesarean section group was 95.17%and 79.69%,The abnormal rate of levator hiatal area in the vaginal delivery group and cesarean section group were 66.18%and 32.81%.The all differences were statistically significant(P<0.05).4.According to the clinical diagnosis standards combing with the ultrasound results,212 cases of postpartum pelvic organ prolapse were detected and the detection rate was 78.23%;44 cases of postpartum stress urinary incontinence were detected and the detection rate was 16.24%.5.The detection rates of postpartum stress urinary incontinence in women with vaginal delivery and cesarean section were 20.77%and 1.56%,and the difference was statistically significant(P<0.05).6.The detection rate of postpartum pelvic organ prolapse in vaginal delivery women and cesarean section women was 86.47%and 51.56%,respectively,the difference was statistically significant(P<0.05);there was a significant difference in the incidence of postoperative pelvic organ prolapse in women with pelvic organ prolapse and postpartum pelvic organ prolapse.(P<0.05),the biparietal diameter of neonates with postpartum pelvic organ prolapse was significantly higher than that of neonates who did not have pelvic organ prolapse.7.The age was a risk factor for stress urinary incontinence(OR=3.541,95%CI:1.312-9.555).Cesarean section was a protective factor for postpartum stress urinary incontinence(OR=0.050,95%CI:0.007-0.382),and was also a protective factor for postpartum pelvic organ prolapse(OR=0.100,95%CI:0.048-0.209).Neonatal double-diameter diameter was a risk factor for postpartum pelvic organ prolapse(OR=9.209,95%CI:3.027-28.017).Conclusion:1.According to the pelvic floor ultrasound results,260 people with abnormal structural abnormalities in 271 cases.There were 187 patients with abnormal bladder neck down distance,accounting for 69.00%.There were 248 patients with abnormal bladder neck rotation angles,accounting for 91.51%.There were 136 patients with abnormal retro vesical angle,accounting for 50.18%of the total number.There were158 persons with abnormal levator hiatal area,accounting for 58.30%.Vaginal delivery had a greater impact on the pelvic floor structure.2.212 cases of postpartum pelvic organ prolapse were diagnosed,accounting for78.23%;44 cases of postpartum stress urinary incontinence were diagnosed by perineal ultrasound,accounting for 16.24%.3.The elderly delivery and delivery methods were the influencing factors of PFD.4.Neonatal double-diameter is a influencing factor for the occurrence of postpartum POP.As the length of the neonatal double-diameter increased,the incidence of POP would also increase. |
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