Pregnancy, Childbirth And Postpartum Pelvic Floor Exercise Pelvic Floor Structure And Function

【Objective】(1)To explore the changes of pelvic floor muscle strength (PFMS) atpostpartum and after pelvic floor muscle rehabilitation therapy, and to appraise theshort-term effect of postpartum pelvic floor muscle rehabilitation therapy.(2)To investigate the effect of pregnancy and spontaneous delivery on the pelvicfloor, we studied the pathologic characteristics of the levator ani muscle which ofwomen with urinary incontinence during pregnancy and after spontaneous delivery.【Methods】(1) Selecting 154 gravidas and dividing them into training team andcontracting team stochastically in order to explore the incidence of SUI and thecondition of pelvic floor muscle of prenatal women in the following periods:theadvanced stage of pregnancy, six to eight weeks and three months after pregnancy.(2)Selecting 80 primipara who accord with the requirement of the study ,andinvestigat them by Chinese Female stress urinary incontinence(SUI) who werepregnancy or delivery and record the condition. After the third stage of labor,biopsyspecimens of levator ani muscle(LAM). LAMS's structure were dyed with thefollowing histological techniques:HE staining,ATPase staining, and were examinedfor the morphological changes, classifying and measuring the muscular fibers.【Results】(1) SUI incidence of six to eight weeks after pregnancy of training teamand contracting team is lower than that of the advanced stage of pregnancy, and thedistinction has statistics'meaning (P<0.05). SUI incidence of the training team ofthree months after pregnancy is lower than that of contracting team and hassignificant difference (P<0.01)。(2)Fifty-three primipara undergone spontaneous delivery among and LAMs'sspecimens were obtained, in which thirty-one had striated muscle tissue (58.49%).(3)Puerperants with SUI had experienced a longer duration in the second stage oflabor than those without SUI.Elongation of the second stage of labor is a risk factor ofSUI after vaginal delivery (Logistic regression coefficient=0.083,P<0.05).(4)The LAMs of the puerperal undergoing vaginal delivery presented Type Imuscular fibers were predominant with both types increasing in diameters.(5)No significant difference was observed between puerperants with SUI andthose without SUI as far as the diameters and ratio of muscular fibers wereconcerned(P>0.05).【Conclusions】(1) Pregnancy and parturition will be harmful to the function of pelvic floor but the function has the tendency of recovery. Pelvic floor muscle training(PFMT)will efficiently prevent postpartum women from the occurrence anddevelopment of SUI.(2)The pathological transform of puerperants'LAM demonstrate that LAM couldbe injured in the process of pregnancy and spontaneous delivery.(3)Elongation of second stage of labor constitutes a risk factor for postpartumSUI,and shorten second stage may reduce the incidence rate of SUI.(4) The changes of morphology,proportions and muscular fiber diameters inLAMs of puerperants were not directly associated with SUI postpartum.(5)The nosogenesis of SUI between puerperants and middle-aged women are notdifferent.The SUI postpartum could be recovery after pelvic floor muscle training.