Takacs Peter, Kozma Bence, Lampé Rudolf, Sipos Attila, Poka Robert
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA.
Department of Obstetrics and Gynecology, University of Debrecen Faculty of Medicine, Debrecen, Hungary.
Obstet Gynecol Sci. 2020 May;63(3):305-314. doi: 10.5468/ogs.2020.63.3.305. Epub 2020 Apr 3.
To improve pelvic floor recovery after vaginal delivery with daily supplementation of a specially formulated postpartum recovery supplement.
Within 48 hours of vaginal delivery, primipara women were randomized in a 1:1 ratio to receive daily oral supplementation for 6 weeks with either a combination of regular prenatal vitamin (PNV), leucine (4 g/day), zinc (30 mg/day) and omega-3 fatty acid (900 mg/day) (treatment group), or only a PNV daily (control group). Co-primary outcomes were vaginal squeeze pressure as measured by perineometer and levator muscle injury as measured by transperineal 3-dimensional tomographic ultrasound at 6 weeks postpartum.
Twenty-six women in the control group and 27 in the treatment group completed the trial. Weak pelvic floor muscle strength was significantly less frequent in the treatment group compared to the control group at 6 weeks after delivery (28% vs. 58%, =0.03). Both right and left-sided levator-urethra gap was significantly larger in the control group compared to the treatment group indicating more levator injury being present in the control group at 6 weeks after delivery. Anterior vaginal wall prolapse at or beyond the hymenal ring was significantly more common in the control group compared to the treatment group (19% vs. 0%, =0.02). Significantly more women reported bothersome bulge symptoms in the control group compared to the treatment group at 6 weeks postpartum (19% vs. 0%, =0.02).
Postpartum women who received a specially formulated postpartum recovery supplement had improved recovery of the pelvic floor after vaginal delivery.
通过每日补充一种特制的产后恢复补充剂，改善阴道分娩后的盆底恢复情况。
在阴道分娩后48小时内，初产妇按1:1比例随机分组，一组每天口服补充常规产前维生素（PNV）、亮氨酸（4克/天）、锌（30毫克/天）和omega-3脂肪酸（900毫克/天）的组合剂6周（治疗组），另一组每天仅补充PNV（对照组）。共同主要结局指标为产后6周时用会阴压力计测量的阴道挤压压力，以及经会阴三维断层超声测量的提肌损伤情况。
对照组26名女性和治疗组27名女性完成了试验。分娩后6周时，治疗组盆底肌肉力量薄弱的发生率显著低于对照组（28%对58%，P=0.03）。与治疗组相比，对照组左右侧提肌-尿道间隙均显著更大，表明分娩后6周时对照组提肌损伤更多。对照组处女膜环处或超出处女膜环的阴道前壁脱垂明显比治疗组更常见（19%对0%，P=0.02）。产后6周时，与治疗组相比，对照组报告有令人烦恼的膨出症状的女性明显更多（19%对0%，P=0.02）。
接受特制产后恢复补充剂的产后女性在阴道分娩后盆底恢复情况得到改善。
