The Effect Of Painless Delivery On Pelvic Floor Function Of In The Early Postpartum Period Is Evaluated By Transperineal Ultrasound

Objective:To observe the early postpartum pelvic organs(such as:bladder,uterus,rectum)and muscles of primiparous women with painful and painless delivery through transperineal ultrasound(TPU)examination,and compare and analyze the relevant data.To analyze the difference between painful delivery and painless delivery on the early postpartum pelvic floor function,explore the effect of labor analgesia on the incidence of pelvic floor dysfunction(PFD).Methods:Two hundred primiparas who had a single and full-term vaginal delivery in the obstetrics department of my hospital from January 2019 to December 2019 and performed pelvic floor ultrasound examination at the Department of Ultrasound Medicine 42 days postpartum were selected.Two hundred primiparas were divided:80 cases in the painless delivery group and 120 cases in the painful delivery group.We observed the continuity of the levator ani muscle and the internal and external anal sphincter through two-dimensional ultrasound.At rest and the maximum Valsalva state,the position of the bladder,the bladder neck,the lowest point of the cervix and the Angle of the anus and rectum were observed,and the inclination angle of the urethra and the posterior angle of the bladder and urethra were measured.And the rotation angle of urethra and the mobility of bladder neck were calculated.We need to observe whether the bladder is expanded,whether the uterus prolapse,whether the rectum is expanded,whether the posterior Angle of the bladder and urethra is open,whether the urethral funnel is formed,whether the mobility of the bladder neck is increased.We observed the continuity of the levator ani muscle and the internal and external anal sphincter through two-dimensional ultrasound in the multi-plane imaging mode or tomographic ultrasound image(TUI)mode through three-dimensional/four-dimensional ultrasound and paid attention to the presence and extent of damage.The hiatus area of the levator ani muscle was measured and We need to analyze whether the hiatus expanded or not.SPSS 26.0 software was used to conduct independent sample t test on the data,and test was used to compare the differences between the data of the pain delivery group and the painless delivery group.Results:Comparison results of general data between the pain delivery group and the painless delivery group:There was no significant difference in age,gestational age,neonatal weight,body mass index and other general information between the two groups.Transperineal ultrasound comparison results of the painful delivery group and the painless delivery group:There was no statistically significant differences in the urethral tilt angle and bladder urethral angle of the women in the painful delivery group and the painless delivery group(P> 0.05).There were no statistically significant differences in the urethral tilt angle,bladder urethral angle,urethral rotation angle,and bladder neck mobility at the time of maximum Valsalva maneuvers in the painful and painless labor groups(P> 0.05).There were no statistically significant differences in bladder prolapse ?uterine prolapse?rectocele?the opened posterior Angle of the bladder?urethral funnel formation?increased mobility of bladder neck and enlarged the hiatus of the levator ani musle hiatus in the painful and painless labor groups(P> 0.05).Conclusion: There was no significant difference in the incidence of pelvic floor dysfunction in the early postpartum period between painless delivery and painful delivery by perineal ultrasound evaluation,and labor analgesia had no significant effect on the early postpartum pelvic floor function of the primiparas.