Evaluation Of Postpartum Pelvic Floor Structure By Ultrasonography And Its Correlation With Estrogen,progesterone And Relaxin Levels In Late Pregnancy

Objective:To evaluate the structure of postpartum pelvic floor by pelvic floor ultrasound,and to explore the correlation between estrogen,progesterone and relaxin in late pregnancy and postpartum pelvic floor ultrasound parameters,so as to provide theoretical basis for the prevention of postpartum PFD.Methods:From December 2019 to August 2020,primipara with full menstrual period and vaginal delivery in our hospital were selected.Blood samples were taken in the third trimester of pregnancy to determine the levels of estrogen,progesterone and relaxin.Pelvic ultrasound examination was performed about 6 weeks after delivery.The movement of bladder neck,rotation angle of urethra,descending distance of cervix,left and right diameter,anterior and posterior diameter and area of levator ani hiatus under the maximum Valsalva state were recorded,According to the results of clinical symptoms,gynecological examination and questionnaire survey,28 cases with pelvic floor dysfunction(abnormal group)and 29 cases without pelvic floor dysfunction(normal group)were selected as the research objects.The differences of ultrasound parameters and hormone levels between abnormal group and normal group were compared,and the correlation between hormone levels and ultrasound parameters was analyzed.Results:The movement of bladder neck,rotation angle of urethra,descending distance of cervix,area of levator ani hiatus under maximum Valsalva state,anterior posterior diameter,left and right diameter in abnormal group were larger than those in normal group,and the difference was statistically significant.There was no rectocele in 57 cases,and the difference was not statistically significant.The level of relaxin in abnormal group was higher than that in normal group,and the difference was statistically significant.The level of estrogen and progesterone in abnormal group was not statistically significant compared with that in normal group.The area and anteroposterior diameter of levator ani hiatus were correlated with left and right diameter,bladder neck movement,urethral rotation angle and descending distance of cervix(r = 0.618,0.579,0.389,0.496,0.463,0.311,P < 0.05);the levels of estrogen and progesterone were not correlated with ultrasound parameters.Conclusion:1.Pelvic floor ultrasound can effectively evaluate the changes of postpartum pelvic floor structure and function,and has important value in detecting postpartum pelvic floor dysfunction.2.Relaxin level in the third trimester of pregnancy has a certain correlation with postpartum pelvic floor structure.With the increase of relaxin level,the supporting effect of pelvic floor weakens.The detection of relaxin level in late pregnancy has a certain reference value in predicting postpartum pelvic floor dysfunction.3.There was no significant correlation between estrogen and progesterone levels and postpartum pelvic floor structure.