Observation Of Urogenital Hiatus And Urethral Mobility After Childbirth In Primipara By Three-dimensional Ultrasound

Objective：This study was designed to observe the urogenitalhiatus and urethral mobility after childbirth in primipara by three-dimensional ultrasound，and evaluate the potential effect of different deliveries on pelvic floor function.Methods：132primipara (postpartum group) and65normal nulliparous women(normal group) were selected.3D translabial ultrasound was performed at rest、contraction and on Valsalva6weeks postpartum．70cases underwent transvaginal delivery(transvaginal delivery group)，and62cases Cesarean delivery(Cesarean delivery group).The following parameters were measured: HA, LR, AP, LUG andurethral mobility. Reproducibility was determined in a test–retest series of10patients. Results：1、The method had good repeatability, with an intraclass correlation coefficient of0.72～0.88.2、With pelvic floor contraction and on Valsalva，the parameters of urogenital hiatus in transvaginal delivery group were significantly larger than the normal group (P<0.05), but at rest there was no significant difference in theparameters of urogenital hiatus between transvaginal delivery groupand normal group(P>0.05)．3、 There were no significant differences in the parameters of urogenital hiatus between Cesarean delivery group and normal group at rest、contraction and on Valsalva (P>0.05).4、With pelvic floor contraction and on Valsalva，the parameters of urogenital hiatus in transvaginal delivery group were significantly larger than the Cesarean delivery group (P<0.05), but at restthere was no significant difference in the parameters of urogenitalhiatus between transvaginal delivery group and Cesarean delivery group (P>0.05).5、Compared to Cesarean delivery group, transvaginal delivery group seem to have a higher risk suffering levator avulsion、vagina abnormality and pelvic organs prolapsed.6、the distal urethra was much less mobile than the proximal urethra in all examiners (P<0.05); Compared to normal group, the whole urethralmobility was significantly increased in postpartum women（P<0.05）.7、Compared to caesarean delivery, vaginal delivery tendto have more marked changes in mobility in five out of six points（P<0.05）.Conclusion:3D translabial ultrasound is an effective evaluationimaging method to observe the urogenital hiatus and urethral mobility. Compared to women with caesarean section，those with vaginal delivery have a higher risks to suffer levator avulsion、pelvic organ prolapsed and have a marked highly urethral mobility. So in order to reduce the occurrence of pelvic floor dysfunction, the primipara should have a rehabilitation training timely after childbirth.