| Objective:To investigate the effect of biofeedback combined with electrical stimulation on pelvic floor function and serum relaxin level in postpartum women,and to explore the efficacy of biofeedback combined with electrical stimulation in the treatment of postpartum pelvic floor dysfunction and its effect on serum relaxin.Method:150 patients with pelvic floor dysfunction diagnosed were selected as the study subjects from January 2014 to June 2017.Which were 6 weeks postpartum accompanied by mild stress urinary incontinence and organ prolapse.The pelvic floor muscle strength test results were less than grade III.All 150 cases had vaginal delivery without severe perineal laceration,including 58 cases of pelvic floor muscle strength I,55 cases of grade II,37 cases of grade III,112 cases of pelvic floor organ prolapse POP-Q stage I,38 cases of grade II.The patients were randomly divided into two groups,90 cases in the observation group were treated with Kegle exercise plus biofeedback combined with electrical stimulation.In the control group,60 cases were treated with pelvic floor muscle Kegle exercise alone.There were no significant differences in age,body mass index,parity,fetal weight,pelvic floor muscle strength,urinary incontinence and severity of pelvic organ prolapse between the two groups.Pelvic floor muscle strength was measured with Oxford score method by hand using and French PHENIX-U4 to test pelvic floor muscle strength of type I and II muscle fibers.The pelvic floor muscle strength was evaluated comprehensively by the two methods,which were divided into 0-V grades.The diagnosis of stress urinary incontinence was subjectively graded by the Ingelman-Sundberg scale developed by the International Urinary Control Association.Organ prolapse was graded according to POP-Q grading standard.Pelvic floor muscle strength was measured before treatment(6 weeks postpartum)and after treatment(3 months and 6 months postpartum).The improvement of urinary incontinence symptoms and the degree of organ prolapse were evaluated.Serum relaxin levels were measured at different time points.To analyze the role and difference of two pelvic floor rehabilitation methods in promoting the recovery of pelvic floor muscle function and the effect on serum relaxin level.Result: Of 150 patients,141 patients completed the follow-up and 9 were lost.Among them,the observation group lost 4 cases in 6 months postpartum,the control group lost 2cases in 3 months postpartum and 3 cases in 6 months postpartum.After treatment,the pelvic floor muscle strength of the patients in the observation group improved significantly after 3 months and 6 months postpartum compared with that before treatment.The proportion of pelvic floor muscle strength grade IV and V was 82.2%(74/90)and 90.7%(78/86)respectively,while that of the control group was 36.2%(21/58)and 45.4%(27/55),respectively.There was significant difference between the two groups(P < 0.05).Compared with those before treatment,82.6%(57/69)and 89.0%(60/69)of patients with grade I-II muscle strength reaching grade III or above were postpartum 3months and 6 months respectively.he control group was 22.7%(10/44)and 40.9%(18/44)respectively,which was significantly higher than the control group(P<0.05),In the observation group,85.7%(18/21)and 71.4%(10/14)of the patients with grade III muscle strength reached grade III or above at 3 months postpartum.The difference was significant(P<0.05).In the observation group,94.1%(16/17)at 6 months postpartum and90.9%(10/11)in the control group.There was no significant difference(P>0.05).2.The symptoms of stress urinary incontinence improved significantly in the observation group.The effective rates of treatment for stress urinary incontinence at 3 months and 6 months after delivery were 88.9%(80/90)and 95.3%(82/86),respectively,which were significantly higher than those of the control group(67.2%(39/58)and 76.3%(42/55),There was significant difference between the two groups(P<0.05)..3.The degree of organ prolapse in the two groups was improved compared with that before treatment.The POP-Q staging 0 degree in the observation group was 42.2%(38/90)and62.8%(54/86)at 3 months and 6 months postpartum respectively,while that in the control group was 24.1%(14/58)and 36.4%(20/55),respectively.The difference was statistically significant(P<0.05).Especially in the patients with grade II prolapse,the improvement rate was 79.1% and 95.85% in 3 months and 6 months,which was significantly higher than that in the control group(14.3% and 28.6%)(P>0.05).4.The serum relaxin levels of the two groups decreased after treatment(3 and 6 months after delivery),but there was no significant difference between the two groups(P>0.05).Conclusion:1.Biofeedback combined with electrical stimulation therapy can promote the recovery of pelvic floor muscle strength in postpartum women,Especially for patients with grade I-II pelvic floor muscle strength,the effect is significantly better than Kegle exercise.2.Biofeedback combined with electrical stimulation therapy can effectively improve the symptoms of postpartum stress urinary incontinence and pelvic organ prolapse,It can be used as a treatment for postpartum symptomatic urinary incontinence and organ prolapse.3.There was no significant difference in serum relaxin level between the two groups.There was no significant correlation between the therapeutic effect of biofeedback combined with electrical stimulation and the decrease of serum relaxin level.Serum relaxin level alone can not be used as an index for predicting and evaluatingpelvic floor function in postpartum women. |
