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经会阴四维超声评估不同分娩方式对产后 6-8 周产妇盆底功能的影响。

Effects of Different Delivery Modes on Pelvic Floor Function in Parturients 6-8 Weeks after Delivery Using Transperineal Four-Dimensional Ultrasound.

机构信息

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.

出版信息

Dis Markers. 2022 May 18;2022:2334335. doi: 10.1155/2022/2334335. eCollection 2022.

Abstract

OBJECTIVE

To evaluate the effects of different delivery modes on pelvic floor function in parturients 6-8 weeks after delivery using transperineal four-dimensional ultrasound.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

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)。

结论

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。

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