Study On The Pelvic Floor Functional Status During Pregnancy And Analysis Of The Effect Of Pelvic Floor Muscle Training Of A Hospital In Daqing City

Objective:To find out pregnant women prevalence of pelvic floor dysfunction disease, and explore the effect prevention PFD by pelvic f1 oor muscle training during pregnancy.Methods :Studied on the pregnant women who check-uped in a maternity clinic of a tertiary level hospital in Daqing City between November 2014 to June 2015, made a investigation of urinary incontinence condition during pregnancy with International urinary incontinence Questionnaire and assessed the situation of pelvic organ prolapse during pregnancy by gynecological examination with pelvic organ prolapse quantilive examination(POP-Q).Made a analysis of the pelvic floor muscle training about the mode of delivery, the influence of postpartum pelvic floor muscle strength and the preventive effect of pelvic floor dysfunction disease.Results :1. pregnant women pelvic floor functional status:① General: 886 cases of pregnant women completed the questionnaire and were assessed POP-Q by gynecological examination, which the nullipara 704, the multipara 182, mid-pregnancy(13 weeks to 27 weeks) 403, late pregnancy(> 27 weeks) 483. Pregnant women, average age 27.82 ± 2.18 years, mean BMI 25.31 ± 4.43 kg / m2, the mean gestational age 29.26 ± 3.72 weeks, the average number of pregnancies 1.55 ± 0.82 times, the average number of deliveries 0.32 ± 0.57 times, the average number of abortions 0.45 ± 0.69 times. It had no statistically significant difference comparing gestational period of the nullipara and the multipara(P> 0.05), and it also had no statistically significant difference comparing different periods of the multipara(P> 0.05).② UI situation:There were 355 UI patients in 886 pregnant women(40.07%),mid-pregnancy UI 98 people(11.06%), late pregnancy UI 257 people(29.01%). UI patients, primipara 236 people(33.52%), the maternal 119 people(65.38%). 236 primipara UI patients, mid-pregnancy 52(16.51%), late pregnancy 184(47.30%). 119 maternal UI patients, mid-pregnancy and 46(52.27%), late pregnancy 73(77.66%).Whether primipara or maternal late pregnancy UI prevalence was significantly higher than the mid-pregnancy, the difference was statistically significant(P <0.05). When the history of vaginal delivery after mid-pregnancy maternal UI prevalence was significantly higher than the maternal history of cesarean section(P <0.05), whereas no significant difference between the two relatively late pregnancy(P> 0.05). Whether or late second trimester of pregnancy, the maternal UI prevalence was significantly higher than early maternal(P <0.05). SUI 265 people(29.91%) in 355 UI pregnant women, MUI 45 people(5.08%), UUI 27 people(3.05%), OUI 18 people(2.03%), SUI, MUI, UUI and constituent ratio were OUI 74.65%, 12.68%, 7.60%, 5.07%. Various types of urinary incontinence in women and the mothers are beginning SUI is the most common, followed by MUI. History of maternal vaginal delivery with SUI is the most common type, followed by UUI, and cesarean places by mothers during pregnancy SUI is the most common type, followed by MUI. Comparison of early maternal and maternal composed of different types of UI, there was no significant difference, P = 0.43. Comparison of different periods and different types of UI pregnancy constitutes no significant difference, P = 0.09. Compare different delivery modes past this pregnancy by mothers of different types of UI does not constitute a significant difference, P = 0.189.③ POP situation: 886 pregnant patients in POP 216 people(24.38%), mid-pregnancy POP 48 people(5.42%), late pregnancy POP 168 people(18.96%). POP patients, primipara 141 people(20.03%), the mothers of 75 people(41.21%). 141 Primipara POP patients, mid-pregnancy and 20(6.35%), late pregnancy 121 people(31.10%). 75 maternal POP patients trimester of pregnancy 28(31.82%), late pregnancy 47(50.00%). Whether or maternal Primipara late pregnancy POP prevalence was significantly higher than the mid-pregnancy, the difference was statistically significant(P <0.05). When the history of vaginal birth after mid-pregnancy maternal POP prevalence was significantly higher than the maternal history of cesarean section(P <0.05), whereas no significant difference between the two relatively late pregnancy(P> 0.05). Whether or late second trimester of pregnancy,the maternal POP significantly higher prevalence of early maternal(P <0.05). POP in 216 cases of pregnant women: a simple anterior vaginal wall prolapse 113 people(52.31%), simple vaginal wall prolapse 45 people(9.72%), uterine prolapse alone 19 people(8.80%), vaginal wall prolapse 45 people(20.83%), anterior vaginal wall prolapse uterine prolapse + 15 people(6.95%), vaginal wall prolapse, uterine prolapse + 3 people(1.39%). 176 patients suffering anterior vaginal wall prolapse(representing 81.48%) of all POP patients, 69 cases suffering from vaginal wall prolapse(accounting for 31.94%), 37 cases of uterine prolapse(accounting for 17.13%), of which there are 63 Examples of the compound there are multiple organ prolapse(29.17%). All pregnant women with POP Ⅰ prolapse 165 people(76.39%), Ⅱ prolapse 43 people(19.91%), Ⅲ prolapse 8 people(3.70%). More than two-thirds of the anterior vaginal wall prolapse simple, simple vaginal wall prolapse, simple uterine prolapse, vaginal wall prolapse, uterine prolapse + anterior vaginal wall prolapse showed Ⅰ prolapse; uterine prolapse + vaginal wall prolapse all manifestations of Ⅱ and Ⅲ prolapse. Comparison of early maternal illness and maternal POP extent, the difference was not statistically significant(P> 0.05). Compared with the second trimester pregnant women in late pregnancy, POP degree of illness was also no significant difference(P> 0.05). POP extent maternal history of illness of the maternal vaginal delivery and cesarean delivery POP prevalence level comparisons, there are significant differences(P <0.05), described the history of vaginal birth after cesarean delivery is higher than the severity of maternal history POP by mothers.2. the effect of pelvic floor muscle exercises: Pelvic floor muscle exercises take pregnant women during pregnancy compared with control group: there was no significant difference in the mode of delivery; typeⅠ and Ⅱ muscle fiber strength than the control group; 6 weeks postpartum SUI and POP the prevalence was significantly lower than the control group.Conclusions :1. Whether maternal primipara or again pregnant, have a higher incidence of pelvic floor dysfunction disease during pregnancy.2. The disease incidence of UI and POP was significantly higher in the later period of pregnancy than in the mid-pregnancy.3. The disease incidence of UI and POP was significantly higher in again pregnant women than primipara.4. The main types of UI during pregnancy was SUI, followed by MUI, UUI, OUI.5.The main pregnancy POP type was the anterior vaginal wall prolapse,andⅠ prolapse was most common.6. It can effectively enhance the maternal pelvic floor muscle strength beginning PFMT in the mid-pregnancy,and it had a positive effect on spontaneous vaginal delivery capacity, and it had a significant effect on the prevention of maternal pelvic floor dysfunction.