Long-term Effects Of Different Perineal Interventions On Pelvic Floor Function In Postpartum Women

Objective:To investigate the long-term effects of different perineal interventions on pelvic floor function in postpartum women.Methods:A total of 256 women who were born in Changzhou Second People's Hospital from October 20 to March 2019 and who did not undergo rehabilitation in the postpartum basin were randomly selected.Among them,122 women who underwent perineal protection after perineal side-cutting were used as observation group(lateral protection group),and 134 women who had unprotected delivery after restriction of perineal side cut were used as control group(no side cut and no protection group).The maternal age,gestational age,labor time,neonatal weight,pregnancy weight change,vaginal temperature sensation,vaginal vibration,postpartum sexual function,postpartuin SUI,postpartum POP.pelvic floor muscle strength,fatigue,Vaginal dynamic pressure.Statistical analysis was performed on the data obtained by SPSS 17.0 statistical software.The measurement data were expressed in the form of mean plus or minus standard deviation(x±s).The comparison between the two groups was performed by independent sample t test.The ?2test or the Fisher's exact test were all statistically significant at p<0.05.Results:1.There were no significant differences in maternal pelvic floor related factors(maternal age,gestational age.neonatal weight,labor time,body weight during pregnancy)(p>0.05).2.postpartum vaginal temperature sensation:the vaginal anterior.vaginal,and clitoris temperature of the lateral protection group(40.01±0.82,39.74±0.90,37.56±0.12)?.all sensitive to no side cut and no protection group(41.61±0.89),40.03±0.83,39.42±0.32)?.(t=2.299,-2.717,-12.859,both p<0.05);3.postpartum vaginal cold sensation:vaginal anterior portion of the lateral protection group,cold sensation at the posterior vaginal(32.07±0.32,32.58±0.38)?,all were s,ensitive to no side cut and no protection group(30.22±0.67.30.91±0.52)?,(t=2.702,3.498,both p<0.05);4.postpartum vaginal vibration sense:side cut The vibratory sensation of the vaginal and clitoris in the protective group(2.54±1.06,1.58±0.67)?m/s was more sensitive than the no-cut unprotected group(6.63±1.05,2.02±0.42)?m/s,(t=-10.939,-6.771,All p<0.05);5.maternal postpartum FSFI-female sexual function:side cut protection group desire,sexual arousal,vaginal lubricity,sexual pain score(3.58±0.32,4.42±0.24,4.69±0.17,4.28±0.26)There was no significant difference in the side cut unprotected group(3.61±0.41,4.50±0.26,4.71±0.31,4.19±0.36)(t=-0.349,0.8).91.1.179,1.716,both p>0.05);side cut protection group orgasm,sexual life satisfaction.total FSFI score(4.06±0.21,4.8±0.26.26.67±0.54)and no side cut unprotected group(3.65±0.33),4.40±0.25.25.56±0.63)were higher(t=2.677.4.499,both p<0.05);6.postpartum SUI occurred:the incidence of SUI in the lateral protection group was 16.39%.which was significantly lower than that in the non-side cut group.(?2=6.445,p<0.05);the total ICI--SF score(11.48±2.450)in the lateral protection group was also lower than that in the no-cut unprotected group(12.68±2.137)(t=-4.198,p<0.05).7.Postpartum POP occurrence:The incidence of maternal POP after delivery is 100%.but all are stage ? and ?.The incidence of POPI in the lateral protection group(68.85%)is higher than that without side cut(52.24%).?2=5.984,p<0.05);The incidence of POP ? in the lateral protection group(31.15%)was lower than that without side cut(47.76%)(?2=6.342,p<0.05);8.pelvic floor electrophysiology:The abnormal rate of maternal class ? muscle strength and fatigue(60.66%,81.96%)in the lateral protection group were lower than those without side cut(73.13%,87.31%).?2=4.511,7.057.p<0.05):the type ? muscle strength and fatigue rate of the side cut protection group(27.05%.23.77%)were lower than those without side cut and no protection group(41.04%.36.57%)(?2=5.545,4.936,p<0.05);the rate of postpartum vaginal dynamic pressure abnormalityin the lateral protection group was 77.05%lower than that in the non-side-cut unprotected group(88.06%)(?2=5.439,p<0.05).Conclusion:1.The results showed that the long-term sensitivity of vaginal sensation was less affected by the non side cutting and unprotected intervention than by the side cutting;2.There was no significant difference in the long-term desire,sexual arousal.vaginal lubrication and coital pain between the two groups;3.The long-term occurrence of Sui and pop was more affected by the unprotected intervention than that after the episiotomy;4.The intervention mode of perineum without lateral incision and without protection in delivery has obvious effect on the long-term injury of pelvic floor type I muscle fiber and vaginal dynamic pressure.