Research On The Correlation Between Pelciv Floor Dysfunction And The Change In Morphological Structure Of Urogenital Hiatus

Objective:The pelvic floor structure was studied by three-dimensional ultrasound,The correlation between pelciv floor dysfunction and the change in morphological structure of urogenital hiatus was studied,To provide clinical evidence for early detection of postpartum PFD and postpartum pelvic floor rehabilitation training.Methods:Sixty-five cases of primiparas whose review in postpartum 6-8 weeks occurred in our hospital from May,2015 to February,2016 were selected as the experiment group,and they were further divided into selective cesarean section(cesarean delivery)group with 30 cases,and vaginal natural delivery(natural labor)group with 30 cases.Meanwhile,cases of 30 females 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.The Voluson E8-type 3D ultrasound Doppler diagnostic instrument of U.S.General Electric Company Ltd.shall be adopted to conduct 3D ultra-sound check.All the examinees receive 3D ultrasound check of their pelvic floor under quiescent condition and Valsalva condition,and 3D 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 Valsalva period.Compare and observe the different features of 3D 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).Analyze the correlation between pelciv floor dysfunction and the change in morphological structure of urogenital hiatus.Results:?The incidence of urinary incontinence in women was higher than that of normal labor group cesarean section group,the difference was statistically significant?Transperineal ultrasonography,bladder mobile delivery group is greater than the cesarean section group,the difference was statistically significant?Perineum 3D 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;?Abnormality 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;?On either quiescent condition or Valsalva 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 Valsalva 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;?The variation quantity of pelvic diaphragm hiatus of both natural labor group and cesarean delivery group in p Valsalva 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.Conclusion:?The resting state,cesarean delivery group and natural laborgroup had no significant difference,but the difference of data that the pregnancy itself due to physiological changes,has caused the change of pelvic floor anatomy.?There was a significant difference between the data of the case group and the contrast group in the largest Valsalva movement,which suggested that the pregnancy and birth had different degrees of damage to the pelvic floor.It is suggested that the changes of the pelvic floor anatomical structure caused by birth may cause postpartum pelvic floor dysfunction.?Three-dimensional pelvic ultrasound with multiplanar imaging work can objectively and clearly display postpartum pelvic diaphragm crack hole and the pubic visceral muscle morphology change,postpartum pelvic floor dysfunction and pelvic diaphragm crack pore structure and morphology is closely related to the change,three-dimensional pelvic ultrasound can be as early screening for postpartum pelvic floor disorders of imaging examination technology.