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| Effects of different delivery methods on the anatomical structure of pelvic diaphragmatic hiatus and bladder neck mobility in postpartum women evaluated by transperineal pelvic floor real-time three-dimensional ultrasound |
| The Second Affiliated Hospital of Chengdu Medical College (The 416th Hospital of Nuclear Industry), Chengdu, Sichuan Province,610051 |
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Abstract To analyze the effects of different delivery methods on the anatomical structure of pelvic diaphragmatic hiatus and bladder neck mobility in postpartum women evaluated by transperineal pelvic floor real-time three-dimensional ultrasound. Methods: The retrospective analysis was performed on the clinical data of 170 puerperae who gave birth in the hospital between January 2020 and October 2021. These puerperae were divided into group A (104 women with vaginal delivery) and group B (66 women with cesarean section) according to the delivery methods. 50 healthy women without childbearing who came to the hospital for examination were enrolled in group C during the same time period. The changes in anteroposterior diameters, left-right diameters, and areas of pelvic diaphragmatic hiatus, and differences of bladder neck mobility of the women at rest, valsala action, and anal contraction action in the 6th weeks and the 3rd month after delivery were compared among the three groups. The women in group A and group B had undergone 3-month pelvic floor function rehabilitation in the 3rd month after delivery, and the changes of strengths of class I and II muscles of the women before rehabilitation and after 3 months of rehabilitation were compared between the two groups. Results: The anteroposterior diameters, left-right diameters, and areas of pelvic diaphragmatic hiatus of the women in group A at rest, valsala action, and anal contraction action in the 6th weeks and the 3rd month after delivery were significantly higher than those of the women in group B，and which of the of the women in group A and B were significantly higher than those of the women in group C. The anteroposterior diameters, left-right diameters, and areas of pelvic diaphragmatic hiatus of the women in group A and B at rest, valsala action, and anal contraction action in the 3rd month after delivery were significantly higher than those of the women in the 6th week. The bladder neck mobility degree of the women in group A and B at rest, valsala action, and anal contraction action in the 3rd month after delivery were significantly lower than those in the 6th week, and which of the women in group A were significantly higher than those of the women in group B (all P＜0.05). After rehabilitation, the strengths of class I and II muscles of the women in group A were significantly lower than those in B. the strengths of class I and II muscles of the women in group A and B after 3 months of rehabilitation were significantly higher than those before rehabilitation (all P＜0.05). Conclusion: There is a significant difference in the anatomical structure of postpartum pelvic diaphragmatic hiatus of the women with different delivery methods, and the influence of vaginal delivery on the anatomical structure is the most. Transperineal pelvic floor real-time three-dimensional ultrasound can intuitively and accurately evaluate the morphological changes of pelvic diaphragmatic hiatus and bladder neck mobility, and which is helpful for early diagnosing the pelvic floor diseases of the women.
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