Ultrasonography Study On The Alteration Of Female Pelvic Floor Structure During Pregnancy And After Delivery

ObjectiveTo provide objective imaging references for clinical study,selected a group of pregnant women and conducted repeated follow-up observations by translabial ultrasound.During different stages of pregnancy and 1 year postpartum,the position and mobility of pelvic floor organs were measured,and the alterations of levator hiatal parameters,contractility and distensibility were observed.All of the parameters were used to investigate the influence of pregnancy and delivery on pelvic floor support structure.MethodsA total of 150 pregnant women were recruited as the observation group,100 nulliparous women were recruited as the control group.The measurement by translabial ultrasound was operated while the musculi levator ani at rest,on contraction and on Valsalva.Measured the position of urethrovesical junction(UVJ),cervix(CV),anorectal joint(ARJ),and calculated their mobility.In addition,measured the levator hiatal anteroposterior diameter(AP),left-right diameter(LR)and hiatal area(HA),and then calculated their contractility and distensibility.The analysis was repeated at 6-8 weeks of gestation,22-24 weeks of gestation,36-38 weeks of gestation,3 days postpartum,42 days postpartum,6 months postpartum and 1 year postpartum.Results1.During the period of pregnancy,positions of UVJ,CV and ARJ gradually descended,their mobilities on contraction decreased,and their mobilities on Valsalva increased.They gradually recovered after delivery.However,the position and mobility of UVJ on Valsalva didn't recover to the normal level after one year since delivery.2.During the period of pregnancy,the levator hiatal of AP,LR and HA gradually increased,the contractility decreased,and the distensibility increased.They gradually recovered after delivery.However,the parameter of HA and its distensibility didn't recover to the normal level after one year since delivery.ConclusionThe pelvic floor supporting structure gradually become slack,and it approaches to the normal level after one year since delivery.However,it can't recover to the normal level completely.