Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, 510630, People's Republic of China.
Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China.
Int Urogynecol J. 2022 Jun;33(6):1511-1520. doi: 10.1007/s00192-021-04789-9. Epub 2021 Jun 16.
The objective of this study was to compare the impact of different modes of delivery, especially forceps delivery (FD), on pelvic floor muscles (PFMs) through vaginal surface electromyography (sEMG) in primiparous women at early (6-8 weeks) postpartum.
A total of 1259 primiparous women with full-term singleton births were included in this cross-sectional study. Of these, 98 were delivered by forceps, 865 underwent spontaneous vaginal delivery (SD) and 296 underwent elective cesarean delivery (CD). Clinical demographic characteristics and vaginal sEMG variables of parturients 6-8 weeks after birth were collected and analyzed using SPSS software. One-way ANOVA with Bonferroni correction, Chi-square test or Student's t-test was used according to the variable type. Spearman correlation and binary logistic regression analyses were also used. P/α ≤ 0.05 was considered statistically significant.
Amplitude of fast and sustained contractions on sEMG in the FD group was significantly lower compared with the CD and SD groups. The sEMG amplitude of all contractions was significantly higher in the CD group compared with the FD and SD groups (P < 0.01). According to binary logistic regression analysis, mode of delivery was a major influencing factor in sEMG.
An early postpartum sEMG test appears to be helpful for the assessment of PFM activity. Mode of delivery was a major influencing factor on sEMG. Forceps delivery significantly inversely influenced PFM activity.
本研究的目的是通过阴道表面肌电图（sEMG）比较不同分娩方式，尤其是产钳分娩（FD）对初产妇产后 6-8 周盆底肌（PFMs）的影响。
本横断面研究共纳入 1259 例足月单胎初产妇。其中 98 例经产钳分娩，865 例自然阴道分娩（SD），296 例行择期剖宫产（CD）。采用 SPSS 软件收集和分析产后 6-8 周产妇的临床人口统计学特征和阴道 sEMG 变量。根据变量类型，采用单因素方差分析（Bonferroni 校正）、卡方检验或 Student's t 检验。还进行了 Spearman 相关分析和二元逻辑回归分析。P/α ≤ 0.05 被认为具有统计学意义。
FD 组 sEMG 快收缩和持续收缩的幅度明显低于 CD 和 SD 组。CD 组所有收缩的 sEMG 幅度均明显高于 FD 和 SD 组（P<0.01）。根据二元逻辑回归分析，分娩方式是 sEMG 的主要影响因素。
产后早期 sEMG 测试似乎有助于评估 PFM 活动。分娩方式是 sEMG 的主要影响因素。产钳分娩显著降低了 PFM 活动。
