文章摘要
胎头吸引联合会阴侧切助产术对初产妇盆底超声的近期影响
The short-term effect of pelvic floor ultrasound in primipara received vacuum extraction delivery combined with lateral episiotomy
投稿时间:2023-03-01  
DOI:10.3969/j.issn.1000-0399.2023.10.008
中文关键词: 三维超声  胎头吸引  盆底功能  会阴侧切
英文关键词: Three-dimensional ultrasound  Vacuum extraction delivery  Pelvic floor function  Lateral episiotomy
基金项目:皖南医学院教学医院自然科学类科研专项基金(编号:JXYY2022107)
作者单位
宋贞英 241000 安徽芜湖 安徽省芜湖市第一人民医院超声医学科 
丁华 241000 安徽芜湖 安徽省芜湖市第一人民医院超声医学科 
肖娴静 241000 安徽芜湖 安徽省芜湖市第一人民医院超声医学科 
李洪梅 241000 安徽芜湖 安徽省芜湖市第一人民医院超声医学科 
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中文摘要:
      目的 评估胎头吸引联合会阴侧切助产术对单胎初产妇盆底超声的近期影响。方法 回顾性分析2021年6月至2022年10月芜湖市第一人民医院分娩的167例单胎初产妇的临床资料及盆底超声数据,其中胎吸+侧切组39例为观察组,经阴道自然分娩128例为对照组。于产后6~8周进行盆底超声检查。观察并评估肛提肌及肛门括约肌损伤情况。测量并比较两组盆底超声相关参数(最大valsalva状态下肛提肌裂孔面积扩张率、膀胱尿道后角开放率、尿道内口开放率、膀胱明显脱垂、子宫脱垂及会阴体过度运动发生率)。结果 观察组产妇年龄、新生儿体质量、胎儿双顶径、胎儿头围及第二产程时长均大于对照组,差异有统计学意义(P<0.05)。两组中均未观察到肛提肌或肛门括约肌损伤。两组产妇的盆底超声参数比较,差异均无统计学意义(P>0.05)。Logistic多因素回归显示胎头吸引联合会阴侧切助产术与最大valsalva状态下产妇的肛提肌裂孔面积扩张[OR (95% CI):1.201(0.547~2.637)]、膀胱尿道后角开放[OR (95% CI):0.657(0.057~7.622)]、尿道内口开放[OR (95% CI):1.285(0.572~2.884)]、膀胱明显脱垂[OR (95% CI):0.996(0.416~2.381)]、子宫脱垂[OR (95% CI):1.621(0.718~3.658)]及会阴体过度运动[OR (95% CI):1.839(0.188~17.946)]的关联均无统计学意义(调整P>0.05)。结论 与经阴道自然分娩比较,胎头吸引联合会阴侧切术的实施对单胎初产妇近期盆底超声无明显影响。
英文摘要:
      Objective To evaluate the short-term effect of pelvic floor ultrasound in singleton primiparous women, who received vacuum extraction delivery combined with lateral episiotomy. Methods In total, 167 primiparas with singleton births, who delivered in the First People's Hospital of Wuhu between June 2021 and October 2022 were included in the study. Among them, 39 had vacuum extraction delivery combined with lateral episiotomy(observation group) and 128 had spontaneous delivery(control group).All puerperas received three——dimensional ultrasound of the pelvic floor 6 to 8 weeks after delivery. Both clinical data and ultrasound data were retrospectively analyzed.The injury of levator ani muscle and anal sphincter was observed and evaluated. The related parameters of pelvic floor ultrasound were measured and compared. The expansion rate of levator ani hiatus area, the rate of opening in posterior urethrovesical angle or internal urethral orifice, the incidence of significant bladder prolapse or uterine prolapse or excessive movement of perineal body were included in the parameters during the maximal valsalva maneuver. Results The maternal age, newborn's body mass, fetal biparietal diameter, fetal head circumference and the second labor duration in the observation group were higher than those in the control group, and the difference was statistically significant(P<0.05).No levator ani muscle or anal sphincter injury was observed in either group. Between the two groups the difference in parameters of pelvic floor ultrasound was not statistically significant(P>0.05).Logistic regression analysis showed that the correlation between vacuum extraction delivery combined with lateral episiotomy and the expansion of levator ani hiatus area[OR(95%CI):1.201(0.547~2.637)], the opening of posterior urethrovesical angle[OR(95%CI):0.657(0.057~7.622)], the opening of internal urethral orifice[OR(95%CI):1.285(0.572~2.884)], significant bladder prolapse[OR(95%CI):0.996(0.416~2.381)], uterine prolapse[OR(95%CI):1.621(0.718~3.658)] and excessive movement of perineal body[OR(95%CI):1.839(0.188~17.946)]during the maximal valsalva maneuverwas not statistically significant(adjusted P>0.05). Conclusions Compared with spontaneous delivery, the implementation of vacuum extraction delivery combined with lateral episiotomy has no significant effect on pelvic floor ultrasound in singleton primiparous women during early postpartum period.
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