Assessment of the influencesof different delivery methods of contractibility of the puborectalis in postpartum women by pelvic ultrasound

doi:10.3877/cma.j.issn.1672-6448.2017.06.011

Abstract

Abstract:

Objective

To assess the recovery of contraction function of puborectalis (PR) in women at different periods after delivery with different delivery modes, and to discuss the effect of delivery mode on PR contraction.

Methods

Between September 2016 and December 2016, 168 primiparas who underwent ultrasound examination at the First Affiliated Hospital of Shenzhen University were enrolled. All participants were able to accomplish Valsalva maneuver. Participants were divided into two groups according to delivery modes: the vaginal delivery group and the cesarean section group. This two groups were further divided into three groups according to their periods after delivery: 42-60 days after delivery (group 1), 61-90 days after delivery (group 2) and more than 90 days after delivery (group 3). Two dimensional translabial ultrasound examination were performed in all participants both at rest and in maximal contraction status. Thickness of anterior, middle and posterior parts of PR were measured and thickening rate was calculated. Data were evaluated by t-test and comparisons were made between the vaginal delivery groups and cesarean section groups, respectively.

Results

In the vaginal delivery group 1, the thickening rate of the anterior, middle and posterior parts of right-side PR were (35.57±19.80)%, (31.46±20.96)% and (24.18±21.51)%, while the thickening rate of left-side PR were (25.23±14.36)%, (21.25±13.79)% and (20.60±11.58)%, respectively. In the cesarean section group 1, the thickening rate of the anterior, middle and posterior parts of right-side PR were (30.27±19.22)%, (29.50±17.21)% and (28.25±14.92)%, while the thickening rate of left-side PR were (33.02±20.65)%, (30.56±20.11)% and (28.64±14.84)%, respectively. In the vaginal delivery group 2, the thickening rate of the anterior, middle and posterior parts of right-side PR were (29.62±16.93)%, (24.94±14.56)% and (19.26±11.12)% , while the thickening rate of left-side PR were (20.17±15.70)%, (19.95±13.07)% and (22.19±14.50)%, respectively. In the cesarean section group 2, the thickening rate of the anterior, middle and posterior parts of right-side PR were (30.82±15.65)%, (17.70±10.34)% and (19.30±7.02)%, while the thickening rate of left-side PR were (18.33±11.61)%, (16.46±10.51)% and (16.62±11.69)%, respectively. In the vaginal delivery group 3, the thickening rate of the anterior, middle and posterior parts of right-side PR were (33.56±19.79)%, (25.18±11.80)% and (17.44±11.41)%, while the thickening rate of left-side PR were (28.06±10.93)%, (22.25±11.82)% and (22.15±12.69)%, respectively. In the cesarean section group 3, the thickening rate of the anterior, middle and posterior parts of right-side PR were (46.36±20.65)%, (17.00±10.34)% and (10.86±3.40)%, while the thickening rate of left-side PR were (22.54±13.81)%, (13.90±10.51)% and (18.24±11.17)%, respectively. There were no statistically difference of the thickening rate of PR in both side between the vaginal delivery subgroups and the cesarean section subgroups (For group 1, right side: t=0.87, P=0.34; t=0.32, P=0.75; t=0.68, P=0.50; left side: t=1.48, P=0.15; t=1.82, P=0.08; t=1.36, P=0.12. For group 2, right side: t=0.22, P=0.83; t=1.64, P=0.11; t=0.01, P=0.99; left side: t=0.43, P=0.67; t=0.79, P=0.44; t=1.13, P=0.27. For group 3, right side: t=0.73, P=0.48; t=1.22, P=0.23; t=0.868, P=0.40. left side: t=0.89, P=0.41; t=1.79, P=0.89; t=0.79, P=0.44).

Conclusion

There was no significant differences between the impact of two delivery modes on the contraction function of the PR, and the protective effect of caesarean section on the contraction function of the PR was limited.

Key words: Ultrasonography, Puborectalis, Cesarean section, Natural childbirth

Hua Chen, Huifang Wang, Jin Wang, Menghua Chen, Juan Guo, Xiaoshuang Deng. Assessment of the influencesof different delivery methods of contractibility of the puborectalis in postpartum women by pelvic ultrasound[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(06): 452-457.

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References 23

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组别	例数	产后42~60 d			产后61~90 d			产后>90 d
组别	例数	例数	年龄（岁）	体重指数（kg/m²）	例数	年龄（岁）	体重指数（kg/m²）	例数	年龄（岁）	体重指数（kg/m²）
经阴道分娩组	100	32	27.81±3.07	22.20±2.95	45	27.89±2.84	21.88±2.56	23	27.87±3.36	22.61±2.86
剖宫产组	68	24	29.33±2.54	21.76±2.28	23	29.13±2.17	22.60±2.68	21	30.58±5.14	22.95±3.09
t值	?	?	1.78	0.53	?	1.55	1.0	?	1.89	0.33
P值	?	?	0.08	0.60	?	0.13	0.32	?	0.07	0.74

组别	例数	产后42~60 d			产后61~90 d			产后>90 d
组别	例数	例数	年龄（岁）	体重指数（kg/m²）	例数	年龄（岁）	体重指数（kg/m²）	例数	年龄（岁）	体重指数（kg/m²）
经阴道分娩组	100	32	27.81±3.07	22.20±2.95	45	27.89±2.84	21.88±2.56	23	27.87±3.36	22.61±2.86
剖宫产组	68	24	29.33±2.54	21.76±2.28	23	29.13±2.17	22.60±2.68	21	30.58±5.14	22.95±3.09
t值	?	?	1.78	0.53	?	1.55	1.0	?	1.89	0.33
P值	?	?	0.08	0.60	?	0.13	0.32	?	0.07	0.74

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