Comparison Of Pelvic Floor Function At Different Stages Of Postpartum Women

Objective:Pregnancy and delivery are the influencing factors of female pelvic floor dysfunction.The existing domestic and foreign studies on the changes of female pelvic floor muscles after childbirth are mostly concentrated in the early postpartum period,while the research on the long-term changes of the pelvic floor after childbirth is relatively small.In this paper,the pelvic floor function of women who delivered through vagina was followed up for a long time to understand the strength of the pelvic floor muscle’s self-recovery ability after delivery and the long-term changes of pelvic floor function.Method:According to the inclusion and exclusion criteria,the full-term singleton vaginal delivery primipara who were 42 days after delivery,1 year after delivery,3years after delivery,and 5 years after delivery were selected from the female pelvic floor urological surgery center of our hospital,with 60 women in each group.Collect basic information including age,height,weight,etc.,and collect relevant data of patients’ POP-Q score,pelvic floor muscle strength,pressure,transperineal twodimensional ultrasound and transvaginal three-dimensional ultrasound.Results:(1)Basic data: There was no significant difference in age and body mass index between the four groups of women(P<0.05).(2)Modified Oxford muscle strength: there was a statistically significant difference in the postnatal muscle contraction ability of the four groups of women(P<0.05).The results of inter-group comparison showed that the modified Oxford muscle strength in the 1-year,3-year and 5-year postpartum groups was higher than that in the 42-day postpartum group(P<0.05).(3)Pelvic organ prolapse degree: There was significant difference in the degree of prolapse of the posterior wall of vagina and genital tract fissure between the four groups(P<0.05).The results of inter-group comparison showed that the degree of vaginal posterior wall prolapse in the 3-year postpartum group and the 5-year postpartum group was greater than that in the 1-year postpartum group(P<0.05);The genital tract fissure in the 5-year postpartum group was larger than that in the 42-day postpartum group and the 1-year postpartum group(P<0.05).(4)The electrophysiological function of pelvic floor muscle: there was a statistically significant difference between the four groups of women’s class I muscle strength,class II muscle strength and vaginal maximum systolic pressure(P<0.05).The results of inter-group comparison showed that class I muscle strength in the 3-year postpartum group was greater than that in the 5-year postpartum group;Class II muscle strength in the 1-year postpartum group and the 3-year postpartum group was higher than that in the 42-day postpartum group(P<0.05);The maximum vaginal systolic pressure in the 1-year postpartum group,3-year postpartum group and 5-year postpartum group was higher than that in the 42-day postpartum group(P<0.05).(5)Two-dimensional ultrasound: There was statistically significant difference in the mobility of bladder neck between the four groups(P<0.05).(6)Three-dimensional ultrasound: There was statistically significant difference in the area of levator ani muscle fissure,the transverse diameter of levator ani muscle fissure and the area of levator ani muscle fissure between the four groups(P<0.05).The area of levator ani muscle in the 3-year postpartum group and 5-year postpartum group was larger than that in the 42-day postpartum group(P<0.05).Conclusion:The pelvic floor function of women who have vaginal delivery can recover themselves in the early postpartum period,but the recovery ability is low.With the progress of time,the pelvic floor function gradually weakened,and the incidence of pelvic floor dysfunction disease increased.The existing domestic and international studies on the changes of pelvic floor muscles in postpartum women are mostly concentrated in the early postpartum period,while the research on the long-term changes of pelvic floor in postpartum women is relatively small.In order to reduce the incidence of pelvic floor dysfunctional diseases in postpartum women,long-term follow-up of pelvic floor function in women with vaginal delivery was conducted to understand the self-recovery ability of pelvic floor muscles and the long-term changes of pelvic floor function.