South Mary M T, Stinnett Sandra S, Sanders Donald B, Weidner Alison C
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Am J Obstet Gynecol. 2009 May;200(5):519.e1-7. doi: 10.1016/j.ajog.2008.12.044. Epub 2009 Mar 9.
The objective of the study was to assess the prevalence of levator ani denervation and reinnervation 6 months after the first delivery.
Ninety-six primigravida women underwent quantitative electromyography of the levator ani during the third trimester and twice postpartum. A 95% confidence interval for normal function was created using interference pattern analysis. Fifty-seven who completed the study are presented in this secondary data analysis. Postpartum muscle sites outside the normal range were considered abnormal. Obstetric and demographic characteristics were assessed.
Of 57 subjects, 70% had no denervation. Of the 30% with denervation at 6 weeks, 35% recovered by 6 months. Obstetric or maternal characteristics were not predictive of denervation or reinnervation, except subjects with persistent denervation tended toward lower body mass index (BMI) independent of mode of delivery.
Nearly one-third of women have levator ani denervation after first delivery, but many recover by 6 months. Denervation is not clearly associated with mode of delivery, but higher maternal BMI may be protective.
本研究的目的是评估首次分娩后6个月时肛提肌去神经支配和再支配的发生率。
96名初产妇在孕晚期及产后接受了两次肛提肌定量肌电图检查。使用干扰模式分析建立正常功能的95%置信区间。在本次二次数据分析中呈现了完成研究的57名产妇的情况。产后肌肉部位超出正常范围被视为异常。评估了产科和人口统计学特征。
57名受试者中，70%没有去神经支配。在6周时出现去神经支配的30%受试者中，35%在6个月时恢复。除了持续去神经支配的受试者倾向于较低的体重指数（BMI）且与分娩方式无关外，产科或母体特征不能预测去神经支配或再支配情况。
近三分之一的女性在首次分娩后出现肛提肌去神经支配，但许多人在6个月时恢复。去神经支配与分娩方式没有明显关联，但较高的母体BMI可能具有保护作用。
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