三维超声评价足月妊娠经阴道分娩中外源激素的应用对盆底功能的影响

Effect of exogenous hormones on pelvic floor function in transvaginal delivery of term pregnancy using 3D ultrasound

目的采用经阴式三维超声评价足月妊娠经阴道分娩中应用外源激素对盆底功能的影响。方法 90名足月经阴道分娩的产妇按使用外源激素情况分为自然分娩组、催产素组和前列腺素E2(PGE2)组,各30名。于产后42天进行超声检查,分别获得静息状态、瓦氏和缩肛动作时盆隔裂孔图像,比较3组产妇盆隔裂孔前后径和面积。结果自然分娩组和催产素组于静息、瓦氏和缩肛动作时盆隔裂孔的前后径、面积测量值差异均无统计学意义(P均>0.05)。PGE2组与自然分娩组、催产素组在静息、瓦氏和缩肛动作时盆隔裂孔测量值差异均有统计学意义(P均<0.05)。结论足月妊娠经阴道分娩中应用不同外源激素的产妇产后盆底功能存在差异,应用外源PGE2对盆底功能的损伤大于应用催产素和自然阴道分娩;应用催产素对盆底功能的影响较自然阴道分娩无差异。

Objective To explore the effect of exogenous hormones on the pelvic floor function in delivery of term pregnancy using transvaginal 3D ultrasound.Methods Ninety puerperae delivered transvaginally were classified into three groups according to exogenous hormones,natural labor group（n=30）,oxytocin group（n=30）and prostaglandin E2 group（n=30）.Hiatal diameter and area at resting,Valsalva,levator ani muscle maximum contraction states were obtained in hiatal images and were compared among 3 groups in 42 days postpartum.Results There were no significant differences of hiatal diameter and area at resting,Valsalva,levator ani muscle maximum contraction state between natural labor group and oxytocin group（all P〈0.05）.There were significant differences of hiatal diameter and area at resting,Valsalva,levator ani muscle maximum contraction state between prostaglandin E2 group and natural labor group,oxytocin group（all P〈0.05）.Conclusion Different exogenous hormones have different effects on the pelvic floor function in delivery of term pregnancy.The injury of the pelvic floor of using prostaglandin E2 is bigger than natural labor and using oxytocin.And the use of exogenous oxytocin is not significant correlated with pelvic floor function injury.