摘要: |
目的 基于2D、3D、4D超声评估阴道自然分娩产前骨盆环疾病孕妇产后盆底功能障碍性疾病(PFD)的发生。方法 选取2020年1月~2023年3月在本院定期产检,并在本院阴道自然分娩的初次妊娠孕妇为研究对象,其中妊娠期间患有骨盆环疾病的150例孕妇为病例组,另按照倾向性匹配原则选取妊娠期间无骨盆环疾病的150例孕妇为对照组。所有纳入孕妇在分娩前行超声检测耻骨联合间隙及骶髂关节,并于经阴道自然分娩后42天采用2D、3D、4D超声评估盆底功能,比较两组孕妇产后PFD发生情况。结果 病例组产后2D超声检查BND参数低于对照组(P<0.05),BSD参数以及静息状态和Valsalva状态时的PUA参数均高于对照组(P<0.05);3D超声检查静息状态和Valsalva状态时的LHLR、LHAP参数均高于对照组(P<0.05);4D超声检查静息状态和Valsalva状态时的肛提肌裂孔最大面积均高于对照组(P<0.05),静息状态和Valsalva状态时的肛提肌厚度均低于对照组(P<0.05)。病例组产后子宫脱垂、阴道前壁膨出、阴道后壁膨出、压力性尿失禁等PFD发生率均高于对照组(P<0.05)。结论 产前患有骨盆环疾病的产妇经阴道自然分娩后运用2D、3D、4D进行盆底超声检查盆底功能,相关参数均较产前无骨盆环疾病的产妇差,产后PFD的发生率更高。 |
关键词: 阴道自然分娩 骨盆环疾病 盆底功能障碍 2D超声 3D超声 4D超声 |
DOI: |
投稿时间:2023-04-10修订日期:2023-05-22 |
基金项目:2D/3D/4D 超声对阴道自然分娩产前盆骨环疾病与产后盆底 功能障碍性疾病相关性的研究HSMCHH2022008 |
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Clinical study on the evaluation of postpartum pelvic floor function in pregnant women with prenatal pelvic ring disease after vaginal natural delivery by 2D/3D/4D ultrasound |
shuhongyan,liweijian |
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Abstract: |
Objective To evaluate postpartum pelvic floor dysfunction (PFD) in pregnant women with prenatal pelvic ring disease after vaginal natural delivery by 2D, 3D and 4D ultrasound. Methods The primiparas undergoing regular prenatal examinations and vaginal natural delivery in the hospital were enrolled as the research objects between January 2020 and March 2023, including 150 cases with pelvic ring disease during pregnancy in case group. According to the principle of propensity matching, 150 pregnant women without pelvic ring disease were enrolled as control group. All underwent ultrasound examination before delivery to detect pubic symphysis space and sacroiliac joints. The pelvic floor function was assessed by 2D, 3D and 4D ultrasound at 42d after vaginal delivery. The occurrence of postpartum PFD was compared between the two groups. Results BND parameters by 2D ultrasound in case group were lower than those in control group (P<0.05), while BSD parameters, PUA parameters in rest and Valsalva state were higher than those in control group (P<0.05). LHLR and LHAP parameters in rest and Valsalva state by 3D ultrasound in study group were higher than those in control group (P<0.05). The maximum area of levator hiatus in rest and Valsalva state by 4D ultrasound in study group was larger than that in control group (P<0.05), and thickness of levator ani was thinner than that in control group (P<0.05). The incidence of PFD (uterine prolapse, encephalocele of anterior vaginal wall, encephalocele of posterior vaginal wall, stress incontinence) in case group was higher than that in control group (P<0.05). Conclusion Compared with women without pelvic ring disease before delivery, relevant parameters are worse and incidence of postpartum PFD is higher in those with pelvic ring disease after after vaginal natural delivery by 2D, 3D and 4D ultrasound. |
Key words: Vaginal natural delivery Pelvic ring disease Pelvic floor dysfunction 2D ultrasound 3D ultrasound 4D ultrasound |