初产妇与经产妇孕期尿失禁及盆底结构情况比较

Comparison Between Unipara and Multipara in Urinary Incontinence and Pelvic Floor Structure During Pregnancy

目的比较初产妇和经产妇孕期尿失禁(UI)症状和盆底结构的差异。资料与方法对229例定期产检的孕妇进行问卷调查,掌握一般资料、产科资料及尿失禁症状,并进行经会阴盆底超声检查。结果经产妇在孕期UI发病率、漏尿频率、漏尿量及对日常生活的影响均大于初产妇,差异均有统计学意义(P<0.05)。孕期发生UI的产妇静息状态下β角及Valsalva状态下α角、β角、裂孔面积和膀胱颈移动度均显著大于无UI症状者,差异均有统计学意义(P<0.05)。经产妇在静息状态下膀胱颈距离耻骨联合后下缘的垂直距离显著小于初产妇,最大Valsalva状态下α角及裂孔面积显著大于初产妇,差异均有统计学意义(P<0.05)。结论经产妇孕期尿失禁症状较初产妇更严重,盆底结构的改变更加显著。

Purpose To compare the differences between unipara and multipara in urinary incontinence(UI)symptoms and pelvic floor structure during multipara.Materials and Methods A total of 229 pregnant women who underwent regular prenatal examination were selected for questionnaire survey regarding general information,obstetric data and symptoms.Meanwhile,they accepted perineal pelvic floor ultrasound examination.Results The morbidity of UI,frequency of urine leakage,volume of urine leakage and effects on daily life during pregnancy were higher in multipara than those in unipara.The differences had statistical significance(P<0.05).The occurrence ofβangle under rest state,αangle andβangle under Valsalva,hiatal area and degree of bladder neck mobility were significantly higher in puerpera with UI than those in puerpera without UI(P<0.05).The vertical dimension between bladder neck and posterior inferior margin of the symphysis pubis under rest state was significantly smaller in multipara than that in unipara.Theαangle and hiatal area under the maximum Valsalva state was significantly larger in multipara than that in unipara(P<0.05).Conclusion Multipara suffers more serious UI symptoms and has more significant changes in pelvic floor structure during pregnancy than those in unipara.