Investigation And Analysis Of Female Menopausal Genitourinary Syndrome In Early Postpartum Period

ObjectiveTo understand the distribution of early postpartum women with menopausal reproductive urinary syndrome and the effect of such diseases on maternal psychology and quality of life,to explore the clinical significance of vaginal health index score in evaluating the vaginal status of early postpartum women,and to find out the related factors leading to early postpartum menopausal reproductive urinary syndrome.Improve the clinical attention to early postpartum menopausal reproductive urinary syndrome,provide data support for the follow-up prevention and treatment of such diseases,and further improve the quality of postpartum examination.MethodsThe subjects were 42-90 days postpartum women who were admitted to Dalian Women and Children Medical Center Group(Obstetrics and Gynecology District)Chang Jiang Road pelvic floor Rehabilitation Center from December 2021 to June 2022.The vaginal and urinary symptoms of menopausal genitourinary syndrome in early postpartum women were investigated one by one by professionals trained by the research group,and the general data and obstetrical information of parturients were recorded.Postpartum pelvic floor examination was carried out by specialist pelvic floor doctors,and vaginal status was evaluated by vaginal health index score.Finally,the disease was diagnosed by more than 2 doctors with deputy senior professional titles combined with medical history,symptoms,signs and auxiliary examination results.At the same time,anxiety,depression and quality of life were evaluated by self-rating anxiety scale(Self-Rating Anxiety Scale,SAS),self-rating depression scale(Self-Rating Depression Scale,SDS)and quality of life score(Quality of Life,Qo L)concise version(Short Form12,SF-12).All the data were analyzed by SPSS25.0 software.Results1.General situation: a total of 392 early postpartum women participated in the survey,the shortest postpartum examination time was 42 days,the longest 90 days,the median 45 days;the youngest 22 years old,the oldest 43 years old,the average 31.55±3.79 years old.Among them,there were 201 menopausal genitourinary syndrome and191 non-menopausal reproductive urinary syndrome.The incidence of early postpartum female postpartum reproductive urinary syndrome was 51.3%.2.Distribution of symptoms in 201 patients diagnosed: 112 cases(55.7%)consciously had reproductive tract symptoms,including 47 cases of lower reproductive tract pain(23.4%),41 cases of burning sensation(20.4%),69 cases of dryness(34.3%),87 cases of decreased libido(43.3%),28 cases of sexual recovery and 15 cases of sexual intercourse pain(53.5%).128 cases(63.7%)had urinary symptoms,including 66 cases of frequent urination(32.8%),95 cases of urgent urination(47.3%),41 cases of nocturnal urination(20.4%)and 46 cases of urinary incontinence(22.8%).3.The average score of vaginal health index was 13.83±2.02 in the research group and 14.47±2.36 in the control group,and there was significant difference between the two groups(P<0.05).The score of vaginal health index was negatively correlated with the disease(r=-0.188,P < 0.05).The use of vaginal health index score has a significant diagnostic efficiency in evaluating the vaginal health status of women in early postpartum period.The best cut-off value is 14.5.Under the cut-off value,AUC=77.1,Kappa value=0.505(P=0.001),sensitivity=76.6%,specificity = 75.3%,consistent percentage = 76.0%.4.Univariate and multivariate analysis of the prevalence of early postpartum menopausal genitourinary syndrome: there were significant differences in age,menstruation recovery,delivery mode,neonatal weight,feeding mode and pelvic organ prolapse between the research group and the control group(P<0.05).Further logistic regression analysis showed that age,mode of delivery,feeding mode and pelvic organ prolapse may be independent risk factors of early postpartum female menopausal genitourinary syndrome.5.The scores of SAS and SDS: the average scores of SAS and SDS in the research group were 37.31±6.53 and 41.79±7.34 respectively,while those of SAS and SDS in the control group were 32.14±4.11 and 35.05±6.59 respectively.The correlation analysis between the scores of SAS scale and SDS scale and the disease condition showed that the score of SAS scale was 0.426,P<0.05,and the score of SAS was 0.436,P<0.05.6.The score of SF-12 scale: the score of healthy quality of life in the research group was-20.18±2.27,and that in the control group was-19.39 ±2.36.There was significant difference between the two groups.The correlation analysis between SF-12 score and disease condition showed that there was no significant difference between the two groups(P<0.05).Conclusions1.The occurrence of menopausal reproductive urinary syndrome in early postpartum women is a common phenomenon,with an incidence of 51.3%.2.The application of vaginal health index score has clinical significance in evaluating the vaginal health status of women in the early postpartum period.3.Appropriate age birth and vaginal delivery are effective measures to reduce early postpartum female menopausal genitourinary syndrome.4.Early postpartum women with quasi-menopausal reproductive-urinary syndrome are more likely to have anxiety and depression,and have lower scores on healthy quality of life,so they need to pay more attention to postpartum postmenopausal reproductive-urinary syndrome.