回顾性分析450例产妇产后盆腔肌筋膜疼痛的发病及影响因素

Retrospective analysis of the incidence and influencing factors of postpartum myofascial pelvic pain in 450 parturients

目的统计产后盆腔肌筋膜疼痛(myofascial pelvic pain,MFPP)的发病情况,探讨妊娠、分娩期不同因素对MFPP的影响,以指导预防。方法收集整个孕期产检及产后复查均在本院进行的产妇临床资料,结合产后42天的盆底检查,按是否存在盆腔肌筋膜疼痛分为两组,对比两组的一般情况及不同分娩方式下疾病的发病情况,分析其影响因素。结果450名产妇中发生MFPP 95人(21.1%),两组产钳助产、阴道顺产、剖宫产者MFPP的发生率(33.3%、24.9%、14.5%)差异有统计学意义(χ^(2)=8.912,P=0.013);孕期体重增加、分娩孕周、新生儿出生体质量是产后MFPP的影响因素(P<0.05)。结论相比剖宫产,阴道分娩特别是伴有产钳助产者,产后盆腔肌筋膜疼痛的发生率明显增加;疼痛的发生可能与孕期体重增加大、分娩孕周延长、新生儿出生体质量大等因素相关。

Objective To investigate the incidence of postpartum myofascial pelvic pain(MFPP)and the influence of different factors during pregnancy and delivery on MFPP,so as to guide the prevention.Methods The clinical data of parturients who were examined in our hospital during the whole pregnancy and postpartum reexamination were collected.On the basis of the pelvic floor examination 42 days postpartum,the enrolled parturients were divided into two groups according to whether there was myofascial pelvic pain or not.The general situation of the two groups and the incidence of diseases under different delivery modes were compared,and the influencing factors were analysed.Results MFPP occurred in 95(21.1%)out of 450 parturients.There were statistically significant differences in the incidence of MFPP among forceps delivery,vaginal delivery and cesarean section(33.3%,24.9%and 14.5%)(χ^(2)=8.912,P=0.013).Weight gain during pregnancy,gestational weeks and birth weight of newborns were the influencing factors of postpartum MFPP(P<0.05).Conclusions Vaginal delivery,especially delivery with forceps,had a significantly higher incidence of postpartum pelvic myofascial pain than cesarean delivery.The occurrence of pain may be related to high body weight gain during pregnancy,prolonged gestational week of delivery,high birth weight of newborns,and other factors.