Chen Yiyao, Xu Chuangchuang, Saiding Qimanguli, Chi Xiaolei, Chu Lei, Wang Xianjing, Chen Xinliang
Department of Obstetrics and Gynecology International Peace Maternity and Child Health Hospital School of Medicine Shanghai Jiao Tong University Shanghai China.
Pelvic Floor Clinic Center International Peace Maternity and Child Health Hospital School of Medicine Shanghai Jiao Tong University Shanghai China.
Smart Med. 2022 Dec 27;1(1):e20220018. doi: 10.1002/SMMD.20220018. eCollection 2022 Dec.
Pelvic floor dysfunction is a common gynecological disease that adversely affects women's quality of life and mental health. Delivery is considered a significant independent risk factor for pelvic floor dysfunction. Surface electromyography (sEMG) values for the pelvic floor muscles (PFM) have been shown to differ according to different delivery modes. This study aimed to compare sEMG results between intrapartum and antepartum cesarean delivery (CD), 42-60 days after delivery. Data of women who underwent CD at the International Peace Maternity and Child Health Hospital were collected from September 2021 to December 2021. Myotrac Infiniti System was used to measure the electromyographic activity of PFM after 42-60 days of parturition. Propensity score matching (1:1) was applied to achieve a balance in baseline data between the two groups (intrapartum and antepartum CD). A total of 200 paired cases were selected for statistical analysis. In the propensity score-matched analysis, there were no statistically significant differences in PFM sEMG between women with antepartum or intrapartum CD ( > 0.05 for all). We observed similar results with postpartum urinary incontinence (24 [12.0] vs. 21 [10.5]; adjusted odds ratio (aOR), 1.12 [95% confidence interval (CI) 0.60-2.12]; = 0.717) and stress urinary incontinence (12 [6.0] vs. 14 [7.0]; aOR, 0.80 [95% CI 0.35-1.80]; = 0.596) as outcomes. After excluding participants with intrapartum CD when the cervix was dilated <6 cm, all sEMG of PFM had a comparable level of risk in both the antepartum and intrapartum CD groups. There were no significant differences in sEMG of the PFM and the incidence of urinary incontinence between patients undergoing intrapartum or antepartum CD. Excluding women who underwent intrapartum CD when the cervix was dilated to <6 cm produced little change in results. Thus, different opportunities for CD may not impact the sEMG of the PFM and the incidence of urinary incontinence.
盆底功能障碍是一种常见的妇科疾病，会对女性的生活质量和心理健康产生不利影响。分娩被认为是盆底功能障碍的一个重要独立危险因素。盆底肌肉（PFM）的表面肌电图（sEMG）值已显示会因不同的分娩方式而有所不同。本研究旨在比较分娩后42 - 60天内剖宫产（CD）产妇产时和产前剖宫产的sEMG结果。收集了2021年9月至2021年12月在国际和平妇幼保健院接受剖宫产的女性的数据。使用Myotrac Infiniti系统在分娩42 - 60天后测量PFM的肌电活动。应用倾向得分匹配（1:1）以实现两组（产时和产前剖宫产）基线数据的平衡。共选择200对病例进行统计分析。在倾向得分匹配分析中，产前或产时剖宫产女性的PFM sEMG无统计学显著差异（所有P > 0.05）。以产后尿失禁（24 [12.0] 对21 [10.5]；调整优势比（aOR），1.12 [95%置信区间（CI）0.60 - 2.12]；P = 0.717）和压力性尿失禁（12 [6.0] 对14 [7.0]；aOR，0.80 [95% CI 0.35 - 1.80]；P = 0.596）为结局时，我们观察到了类似的结果。在排除宫颈扩张<6 cm时进行产时剖宫产的参与者后，产前和产时剖宫产组中PFM的所有sEMG风险水平相当。产时或产前剖宫产患者的PFM sEMG和尿失禁发生率无显著差异。排除宫颈扩张至<6 cm时进行产时剖宫产的女性对结果影响不大。因此，不同的剖宫产时机可能不会影响PFM的sEMG和尿失禁发生率。
