Evaluation of effect of parity on levator ani hiatus in early postpartum women by transperineal pelvic floor ultrasound
Objective To investigate the relationship between increased pars and levator ani hiatus dilation and the poten-tial effect on the risk of pelvic organ prolapse(POP)by quantitatively analyzing the changes of levator ani hiatus in early post-partum women with different parity by transperineal pelvic floor ultrasound.Methods A retrospectively observational nest case control study was carried out.Eligible participants included 809 postpartum women.The participants were divided into three groups according to parity:first parity group(328 cases),second parity group(340 cases)and third parity group(141 cases).The anteroposterior diameter(LHA),left and right diameter(LHD)and area(HA)of levator ani hiatus of the participants were measured using transperineal pelvic floor ultrasound during the resting and Valsalva maneuver states,the changes of the parameters(ΔLHA,ΔLHD,ΔHA)during Valsalva movements compared with resting states were calculated and these parame-ters were then compared pairwise between the three groups.Results(1)Changes of parameters of levator ani hiatus:With the parity increased,LHA,LHD and HA increased in both resting and Valsalva movements,and the differences of the parameters between the first and second parity groups were statistically significant(P＜0.05),while the difference of HA between the sec-ond and third parity groups was statistically significant only during Valsalva movements(P＜0.05).(2)Expansion of levator ani hiatus:During the Valsalva maneuver,the increase of parameters of levator ani hiatus(ΔLHA,ΔLHD,ΔHA)increased with the increase of parity,and the increase of ΔHA was the most obvious;The incidence of moderate and severe dilatation of the levator ani hiatus in the first,second and third parity groups was 1.22％,4.71％and 12.06％,respectively,and the differ-ence of positive rate was statistically significant(P＜0.01).Conclusion The increase of parities is significantly associated with degree of levator ani hiatus dilation,which may increase the risk of pelvic organ prolapse in postpartum women.
transperineal pelvic floor ultrasoundparitylevator ani hiatus dilationpelvic organ prolapse
万方数据
维普
