Effect Of The Second Stage Of Labor Time On Pelvic Floor Function Under The New Stage Of Labor

Objective:The second stage of labor is one of the causes of pelvic floor dysfunction in women.In 2014,the Obstetrics Group of the Branch of Obstetrics and Gynecology of the Chinese Medical Association put forward the Expert Consensus on the Standards and Treatment of the New Labor Process based on the literature summarized by the actual situation at home and abroad,and proposed to increase the time of the second labor process by 1 hour on the original basis,that is,the time of the second labor process for primipara undergoing epidural anesthesia can be relaxed to 4 hours.At present,domestic research mainly focuses on the implementation of a new labor process,mainly focusing on postpartum complications such as postpartum hemorrhage and neonatal prognosis.There is little research on the early pelvic floor function of postpartum women after the implementation of a new labor process.Currently,whether the second stage of labor under the new labor process standard management will increase the damage to pelvic floor function in postpartum women has become a hot topic of discussion.This study mainly discusses the impact of the second stage of labor time under the management of new labor standards on the pelvic floor function of primiparous women under epidural anesthesia with natural delivery and no trend of difficult labor,in order to provide a reference basis for clinical comprehensive evaluation of the second stage of labor time.Methods:This study is a retrospective study.A total of 240 patients xxx center of our hospital from January 2020 to December 2022 after 6 to 8 weeks postpartum were selected.All subjects filled in questionnaires,collected relevant data and medical records,and trained gynecologists and obstetricians evaluated the pelvic floor function of the enrolled primipara at 6 to 8 weeks postpartum,including pelvic organ prolapse,Pelvic floor function was evaluated by two-dimensional and three-dimensional ultrasound and pelvic floor muscle strength measurement.To compare the effect of the second stage of labor under the management of the new stage of labor standard on the pelvic floor function of women in the early postpartum period.Results:A total of 240 cases were collected,and the study group(Group A)was divided into three groups according to the length of the second stage of labor(t):group A1 with 2 h≤t<2.5 h,40 cases in total;Group A2 with 2.5 h≤t<3 h,43 cases in total;Group A3 with t≥3 h,37 cases in total;T<2 h was the control group(group B),120 cases in total.1.There was no significant difference in general obstetric data such as age,prenatal BMI and weight gain during pregnancy among the three groups.2.In terms of pelvic organ prolapse,in the bulge of the anterior wall of the vagina,in the four groups,the anterior wall of the vagina I There were more degree bulges,and there was no significant difference between the three groups(P=0.660);In the bulge of the posterior wall of the vagina,in the four groups,the posterior wall of the vagina I There were more degree bulges,and there was no significant difference between the three groups(P=0.093);In uterine prolapse,in four groups,uterine prolapse I There was no significant difference between the three groups(P=0.066).3.In terms of two-dimensional ultrasound measurement of the pelvic floor,there was no statistically significant difference between the three groups in the distance between the horizontal lines of the urethral funnel,the bladder neck and the posterior lower edge of the pubic symphysis(BND),the distance between the horizontal lines of the bladder bottom and the posterior lower edge of the pubic symphysis(BSD),the urethral inclination angle,and the anal right angle.4.In terms of three-dimensional ultrasound measurement of pelvic floor,there was no statistically significant difference in the area of levator ani fissure,the transverse diameter of levator ani muscle,and the anteroposterior diameter of levator ani muscle between the three groups.5.In terms of pelvic floor muscle strength,there was no statistically significant difference between the three groups in the comparison of Ⅰ and Ⅱ muscle strength.Conclusion:The second stage of labor under the management of the new labor process standard has no significant impact on the pelvic floor function of primiparous women under epidural anesthesia with natural delivery and no trend of difficult labor in the early postoperative period.