Clinical Study Of Natural Rehabilitation Of Postpartum Pelvic Floor Function

Objective1、To evaluate postpartum women’s pelvic floor function of the self rehabilitation in the absence of any intervention treatment,2、To explore the related factors of postpartum female pelvic floor function and the opportunity to exercise the pelvic floor function.Methods80 postpartum review women were enrolled in the experimental group in the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from Jan 1, 2015 to Dec 31,2015. (group A,40 for the vaginal delivery of primipara, group B,40 for selective cesarean delivery of primipara) and 30 non-pregnant woman who have sexual history were chosen as the control group.General information (age, height, weight, occupation before pregnancy),perineum, urinary incontinence, vaginal wall prolapse after dilevery and type Ⅰ, Ⅱ pelvic floor muscle strength after 42 days and 3 months postpartum were recorded for the experimental group. Meanwhile, type Ⅰ,Ⅱ pelvic floor muscle strength were also examined in the control group. All the data were analyzed with SPSS 18.0 software.Results1. Comparison of the three groups’ pelvic floor muscle strengthNo matter the mode of delivery, pelvic floor type Ⅰ and type Ⅱ muscle strength were significantly lower than those of control group 42 days or 3 months after the delivery and there was a statistically significant difference (P<0.01).2. Comparison of primipara 42 days and 3 months after deliveryWithout any postpartum pelvic floor functional exercise, the vaginal delivery and selective caesarean section all maternal postpartum 3 months of type Ⅰ muscle and type Ⅱ muscle strength compared to 42 days after are improved, and the difference was statistically significant (P<0.01).3. Comparison of the incidence of postpartum vaginal wall prolapse and SUI after different delivery modesPrimipara vaginal wall prolapse rate after selective cesarean section was significantly lower than that after vaginal delivery. The difference was statistically significant (P<0.05); rate of SUI after selective cesarean section was not statistically different from that after vaginal delivery (P>0.05). The incidence of primipara after 3 months of PFD is lower than that after 42 days post delivery, but the difference was not statistically significant (P>0.05).4. Effects of different obstetric factors on postpartum vaginal wall prolapse and SUI incidence rate:Postpartum pelvic floor dysfunction rate in patients with overweight was significantly higher than those with normal BMI before pregnancy, and the difference was statistically different (P<0.05); postpartum vaginal wall prolapse incidence was higher in patients with babies with higher neonatal birth weight increased, the difference is statistically significant (P <0.05), and postpartum urinary incontinence with neonatal birth weight increase did not change significantly, the difference was not statistically significant (P>0.05); primipara different gravidity, occupation and age of the onset of postpartum PFD rate had no significant effect, the difference was not statistically significant (P>0.05). BMI before pregnancy, birth weight and postpartum vaginal wall prolapse incidence was positively correlated (P<0.05), and incidence of SUI was no correlation (P>0.05),different age, occupation, age and the incidence of postpartum vaginal wall prolapse and SUI no correlation (P>0.05).Conclusions1.Without any intervention, pelvic floor muscle strength recovered to around 55% of normal non-pregnant controls 3 months after vaginal delivery, whereas pelvic floor muscle strengthrecovered 83% of normal non-pregnant controls 3 months post selective cesarean section delivery.2.Preconception BMI, neonatal birth weight and mode of delivery and other factors affect postpartum PFD incidence. However, maternal age, occupation and pregnancy time do not affect the incidence of postpartum PFD.3.No matter the mode of delivery, postpartum pelvic floor function was lower than normal, especially after vaginal delivery. In order to reduce the occurrence of postpartum PFD, it’s necessary to do pelvic floor exercise as soon as possible after delivery.