Research On The Value Of Morphological Observation And Functional Assessment Of Postpartum Pelvic Diaphragm Hiatus By3D Ultrasound

Objective The aims of this paper is to investigate the value of perineum3D ultrasound in the morphology and functional assessment of pelvic diaphragm hiatus of the females who suffer no pelvic floor dysfunction in early postpartum period.Methods Sixty-five cases of primiparas whose review in postpartum6-8weeks occurred in our hospital from May,2013to February,2014were selected as the experiment group, and they were further divided into selective cesarean section (cesarean delivery) group with31cases, and vaginal natural delivery (natural labor) group with34cases. Meanwhile, cases of30females with no birth abortion experience receiving clinical treatment in the obstetrics department of our hospital during the corresponding period are chosen as the contrast group. Use vaginal palpation method to check the muscle strength of levator ani muscle when it contracts, and grade it based on Oxford muscle strength grading. The Voluson E8-type3D ultrasound Doppler diagnostic instrument of U.S. General Electric Company Ltd. shall be adopted to conduct3D ultra-sound check. All the examinees receive3D ultrasound check of their pelvic floor under quiescent condition and anus contracting condition, and3D ultrasonograms of pelvic diaphragm hiatus under both conditions are acquired and the anteroposterior diameter (AP), left-right diameter (LR) and area (HA) of the pelvic diaphragm hiatus are respectively measured. Calculate the variation quantity of pelvic diaphragm hiatus under anus contracting condition with reference to the formula, that is, the area variation quantity of pelvic diaphragm hiatus (As), the anteroposterior diameter variation quantity (Ps), and left-right variation quantity (Rs) in anus contracting period. Compare and observe the different features of3D ultrasound imaging of pelvic diaphragm hiatus of the females in early postpartum (including natural labor group and cesarean delivery group) and those who have never given birth. Compare the differences in the rate of abnormality of the internal and external structures of pelvic diaphragm hiatus between the natural labor group and cesarean delivery group. Compare the size of pelvic diaphragm hiatus (HA、AP、LR), the variation quantity of pelvic diaphragm hiatus in anus contracting period(As、Ps、Rs) and the grading of levator ani muscle strength between contrast group, natural labor group and cesarean delivery group. Analyze the correlation between the variation quantity of pelvic diaphragm hiatus in anus contracting period and Oxford muscle strength grading.Results①Perineum3D ultrasound check can clearly reveal the anatomical structure of the pelvic floor of females after delivery. Abnormalities in pelvic diaphragm hiatus in early postpartum include: paramorphia of pelvic diaphragm hiatus, abnormality in the morphology and shape of levator ani muscle, and paramorphia of the cross section of pelvic organs, etc;②Abnormality rate of the internal and external structure of pelvic floor of natural labor group is higher than that of cesarean delivery group, with difference carrying statistical significance, P<0.05;③On either quiescent condition or anus contracting condition, pelvic diaphragm hiatus of both natural labor group and cesarean delivery group is higher than that of the contrast group, with difference carrying statistical significance, P<0.05. Under anus contracting condition, pelvic diaphragm hiatus of natural labor group is higher than that of cesarean delivery group, with difference carrying statistical significance, P<0.05, while under quiescent condition, although pelvic diaphragm hiatus of natural labor group is also higher than that of cesarean delivery group, difference carries no statistical significance, P>0.05;④The variation quantity of pelvic diaphragm hiatus of both natural labor group and cesarean delivery group in anus contracting period is smaller than that of the contrast group, with difference carrying statistical significance, P<0.05. The variation quantity of pelvic diaphragm hiatus of natural labor group in anus contracting period is smaller than that of cesarean delivery group, and the difference carries statistical significance, P<0.05;⑤Muscle strength of natural labor group and cesarean delivery group is comparatively weaker than that of the contrast group, and muscle strength of natural labor group is weaker than that of cesarean delivery group, with difference carrying statistical significance, P<0.05;⑥The area variation quantity of pelvic diaphragm hiatus (As), the anteroposterior diameter variation quantity (Ps), and left-right variation quantity (Rs) in anus contracting period are positively correlated to Oxford muscle strength grading, and the correlation index is between0.40and0.53.Conclusion The3D pelvic floor ultrasound examination with multi plane imaging function is an imageological testing technology for that can give an objective and thorough display of early-phase postpartum pelvic diaphragm hiatus and its internal structure variation for screening the early-stage postpartum pelvic disorders.The3D ultrasound evaluation method of Levator ani’s contractibility can effectively assess different contraction functional status of the levator ani, and can predict the occurrence tendency of the postpartum pelvic disorders, which provides a certain prospect of clinical application.