3D-pelvic Floor Ultrasound Combined With Pelvic Floor Muscle Strength Assessment In Postpartum Pelvic Floor Function Assessment

Objective To explore the application value of 3D-pelvic floor ultrasound combined with pelvic floor muscle strength evaluation in postpartum pelvic floor function assessment,and to provide a reliable objective basis for early detection of postpartum pelvic floor function decline and postpartum pelvic floor muscle function repair.Methods 106 cases of puerpera who underwent re-examination at six-ten weeks postpartum in the First Hospital of Huai ’an Affiliated Hospital of Nanjing Medical University from April to August 2019 were selected as subjects.According to different delivery methods,106 parturients were divided into 65 cases of vaginal natural delivery and 41 cases of selective cesarean section.In addition,80 married women without abortion and childbearing history who underwent physical examination in our hospital during the same period were selected as the control group.All three groups received 3D-pelvic floor ultrasound examination and pelvic floor muscle strength evaluation.(1)Using the 3D reconstruction mode to obtain the minimum pelvic hole plane,the anteroposterior diameter(AP),left and right diameter(LR),and area(HA)of the pelvic sulcus were measured under resting and contracted anus conditions.The differences in maternal(including vaginal delivery and cesarean section)and non-fertile women with pelvic hole-related parameters(AP,LR,HA)in resting and contracted anal state were compared;(2)Using Pelvic floor electromyography,through electromyography tracing the subjects fast evaluation stage,the mixed muscle,slow muscle evaluation phase electrical activity of the pelvic floor muscles electromyography signals,to quantify the different muscle fibers voltage value,the determination of fast muscle maximum electrical values,mixed muscle average electrical values and slow muscle average electrical values,the differences of fast muscle maximum electrical values,average electrical values,slow muscle average electrical values of the above subjects were compared with muscle maximum electrical values,average electrical values,slow muscle average electrical values of vaginal delivery,cesarean sections and childless women groups.Results The AP,LR and HA values of the vaginal delivery group and the cesarean section group were significantly higher than those of the control group(P<0.05).There was no significant difference in AP,LR and HA values between the vaginal delivery group and the cesarean section group(P>0.05).The AP,LR and HA values in the vaginal delivery group were significantly higher than those in the cesarean section group(P<0.05).The maximum myoelectric value of fast muscle,mixed muscle and slow muscle in the control group were significantly higher than those in the vaginal delivery group and cesarean section group,while the maximum myoelectric value of fast muscle,mixed muscle and slow muscle in the vaginal delivery group were significantly lower than those in the cesarean section group(P<0.05).Conclusion Both vaginal delivery and cesarean delivery have a certain degree of change in the structure and function of the pelvic floor support.Compared with vaginal delivery,cesarean section has less damage to the contraction function of levator ANI.Compared with childless women,the maximum contraction force and continuous contraction force of pelvic floor muscle of postpartum women are significantly reduced,and the reduction of pelvic floor muscle force of women with vaginal delivery is larger than that of women with cesarean section,and the pelvic floor muscle force is the weakest.The combination of 3D-pelvic floor ultrasound examination and pelvic floor muscle strength assessment can comprehensively evaluate the situation of puerpera in the early postpartum pelvic floor.