Graduate School, Tianjin Medical University, Tianjin City 300070, China.
The No. 2 Department of Ultrasound, Binzhou No. 2 People's Hospital, Binzhou, Shandong Province 256800, China.
Dis Markers. 2022 May 18;2022:2334335. doi: 10.1155/2022/2334335. eCollection 2022.
To evaluate the effects of different delivery modes on pelvic floor function in parturients 6-8 weeks after delivery using transperineal four-dimensional ultrasound.
Pelvic floor function 6-8 weeks after delivery in 40 vaginal delivery parturients between November 2018 and December 2020 was assessed by four-dimensional ultrasound, with 40 selective cesarean section delivery parturients as a control group. The imaging results of the two groups were compared.
The levels of clinical indexes such as UVJ-M, , , , , , and ARJ-VDv in the selective cesarean section group were significantly lower than those in the vaginal delivery group 6-8 weeks after delivery ( < 0.05). However, no significant difference in CV-VD was observed under Valsalva action and at rest between the two groups ( > 0.05). No significant difference in ARJ-VD was found at rest between the two groups ( > 0.05). The incidence of pelvic organ prolapse in the selective cesarean section group (40.0%) was significantly lower than that in the vaginal delivery group (62.5%) ( < 0.05). No significant difference in the parameters of pelvic diaphragm hiatus at rest was observed between the two groups ( > 0.05). The parameters of pelvic diaphragm hiatus under maximum Valsalva action in the vaginal delivery group were significantly higher than those in the selective cesarean section group ( < 0.05). Whether the patient was complicated with diabetes had no significant effect on the functional injury of pelvic floor muscle ( > 0.05).
The pelvic floor function 6-8 weeks after delivery was significantly more affected in vaginal delivery than in selective cesarean section. Selective cesarean section had certain but limited protective effect on maternal pelvic floor tissue.
应用经会阴四维超声评估产妇产后 6-8 周不同分娩方式对盆底功能的影响。
选取 2018 年 11 月至 2020 年 12 月 40 例阴道分娩产妇为观察组，另选取同期 40 例选择性剖宫产产妇为对照组，产后 6-8 周行四维超声盆底功能评估，比较两组产妇的影像学检查结果。
选择性剖宫产组产妇产后 6-8 周时 UVJ-M、AP、MP、CC、CI、ARC、ARJ-VDv 等临床指标水平均明显低于阴道分娩组（ < 0.05），但两组产妇在 Valsalva 动作及静息状态下的 CV-VD 比较差异无统计学意义（ > 0.05），静息状态下的 ARJ-VD 比较差异无统计学意义（ > 0.05）；选择性剖宫产组产妇产后盆腔器官脱垂发生率（40.0%）明显低于阴道分娩组（62.5%）（ < 0.05），两组产妇静息状态下的盆底裂孔膈肌参数比较差异无统计学意义（ > 0.05），但阴道分娩组产妇在最大 Valsalva 动作时的盆底裂孔膈肌参数明显高于选择性剖宫产组（ < 0.05）；是否合并糖尿病对产妇盆底肌肉功能损伤无明显影响（ > 0.05）。
阴道分娩对产妇产后 6-8 周的盆底功能影响明显大于选择性剖宫产，选择性剖宫产对产妇盆底组织有一定但有限的保护作用。
