不同分娩方式产妇产后早期盆底功能影响因素分析

Influencing factors of pelvic floor function of early postpartum period in parturients with different delivery modes

目的:探讨不同分娩方式的产妇产后早期盆底功能影响因素的差别,降低选择性剖宫产率及产后早期盆底肌异常发生率。方法:回顾性分析2016年1月1日至2018年10月31日在郑州市妇幼保健院住院分娩且产后6~8周来本院进行产后回访的产妇5606例,根据分娩方式分为阴道分娩组(2852例)和剖宫产组(2754例),对母儿一般情况进行调查分析,采用logistic回归分析影响产妇产后早期盆底功能的影响因素。结果:阴道分娩组Ⅰ、Ⅱ类肌肌力,Ⅰ、Ⅱ类肌疲劳度,阴道壁静态压力值异常率均达到60%以上,剖宫产组也均达到40%以上。影响阴道分娩产妇产后早期盆底功能的因素主要有年龄、孕次、新生儿体重、产前BMI、孕期增加BMI、总产程及第二产程时间;影响剖宫产产妇产后早期盆底功能的因素主要有年龄、孕次、产次、分娩孕周、孕期增加BMI和是否阴道试产。结论:选择性剖宫产并不能避免盆底肌异常的发生,做好孕期管理可以降低产后早期盆底肌异常率。

Aim:To analyze the influencing factors of pelvic floor muscle function of early postpartum period in parturients with different delivery modes,in order to reduce the rate of selective cesarean section and abnormality incidence of pelvic floor muscle.Methods:The parturients women(5606 cases)were collected.They deliveried and postpartum tested after delivery 6 to 8 weeks in the Women and Infants Hospital of Zhengzhou during Jan 1st 2016 to Oct 31st 2018,who were allocated into vaginal delivery group(2852 cases)and cesarean section group(2754 cases)according to the delivery mode.The general situation of mothers and children were investigated,and logistic regression was used to analyze the influencing factors of early postpartum pelvic floor function.Results:The abnormal rate ofⅠ,Ⅱmuscle strength,Ⅰ,Ⅱmuscle fatigue,vaginal wall static pressure in vaginal delivery group reached more than 60%,and the abnormal rate in cesarean section group also reached more than 40%;Age,the times of pregnancy,neonatal weight,perinatal BMI,increased BMI during pregnancy,the total stage of labor time and the second labor time were the main factors affecting pelvic floor muscle function of women in vaginal delivery group;Age,the times of pregnancy,the times of delivery,the gestational weeks of delivery,increased BMI during pregnancy,and whether vaginal trial production were the main factors affecting the pelvic floor muscle function of women in cesarean section group.Conclusion:Selective cesarean section could not avoid abnormality incidence of pelvic floor muscle.Well management during gestation period can reduce the abnormality incidence.