Zhang Xinxin, Zhang Xiangjian, Wang Yaoyao, Huang Xianping, Chen Xiangyu, Wang Ledan
Department of Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Wenzhou Central Hospital, Wenzhou, China.
Ann Palliat Med. 2021 Mar;10(3):3386-3395. doi: 10.21037/apm-21-485.
The present study sought to investigate the short-term effects of different delivery methods on postpartum pelvic floor function in Chinese primiparas.
Primiparous women who delivered a full-term, cephalic, singleton infant at our hospital between January 1, 2018 and August 15, 2019 were recruited into this study. All women underwent pelvic floor function screening at 6-8 weeks postpartum. Tests included postpartum Pelvic Organ Prolapse Quantification (POP-Q) score, incidence of urinary incontinence, pelvic floor muscle (PFM) strength, and Pelvic Floor Distress Inventory Questionnaire-Short Form 20 (PFDI-20) score.
A total of 284 postpartum women were recruited into the study. Of the participants, 147 had undergone vaginal delivery, 37 had undergone intrapartum cesarean delivery (ICD), and 100 had undergone elective cesarean delivery (ECD). Points Aa, Ba, Ap, and Bp showed a greater degree of prolapse in the vaginal delivery group than in the ECD group (P≤0.05). UI was less prevalent in ECD group relative to the vaginal delivery group (P≤0.05). Tonic PFM contraction was weaker in the vaginal delivery group than in the ECD and ICD groups (P≤0.05). Significant differences were also observed between the vaginal delivery group and the ECD group with respect to PFDI-20 scores (P≤0.05).
Compared with vaginal delivery, ECD was strongly linked to a lower risk of pelvic organ prolapse (POP) and UI, stronger tonic PFM strength, and lower PFDI-20 scores. ECD confers relatively better protection against pelvic floor dysfunction (PFD) than does ICD.
本研究旨在探讨不同分娩方式对中国初产妇产后盆底功能的短期影响。
选取2018年1月1日至2019年8月15日在我院分娩足月、头位、单胎婴儿的初产妇纳入本研究。所有产妇在产后6 - 8周进行盆底功能筛查。检查项目包括产后盆腔器官脱垂定量（POP-Q）评分、尿失禁发生率、盆底肌肉（PFM）力量以及盆底困扰量表简表20（PFDI-20）评分。
共284名产后妇女纳入本研究。其中，147名经阴道分娩，37名接受产时剖宫产（ICD），100名接受择期剖宫产（ECD）。Aa、Ba、Ap和Bp点的脱垂程度在阴道分娩组比择期剖宫产组更严重（P≤0.05）。择期剖宫产组尿失禁的发生率低于阴道分娩组（P≤0.05）。阴道分娩组的盆底肌肉张力性收缩比择期剖宫产组和产时剖宫产组弱（P≤0.05）。阴道分娩组和择期剖宫产组在PFDI-20评分方面也存在显著差异（P≤0.05）。
与阴道分娩相比，择期剖宫产与盆腔器官脱垂（POP）和尿失禁风险较低、盆底肌肉张力性力量较强以及PFDI-20评分较低密切相关。与产时剖宫产相比，择期剖宫产对盆底功能障碍（PFD）的保护作用相对更好。
