Study on the effects of multimodal ultrasound evaluation of parity on the function of the perineal body and the levator ani muscle in parturients
Objective To investigate the effect of parity on the function of perineal body(PB)and levator ani muscle(LAM)in early postpartum period of natural childbirth by using two-dimensional gray scale ultrasound combined with real-time shear wave elas-tography(SWE).Methods Natural delivery women(6～8 weeks postpartum)in Nanchong Central Hospital were selected.According to the parity,the study subjects were divided into a secondary multipara group(n=46)and a primipara group(n=55).Another 50 healthy women with history of sexual intercourse and childlessness who came to our hospital for examination during the same period were selected as a control group.The length,height,and Young's modulus of the perineal body in three groups under resting and maximum contraction conditions,as well as the Young's modulus values of the bilateral levator ani muscles under resting,maximum contraction,and Valsalva conditions were measured,The differences were calculated.The changes in ultrasound parameters under different states in each group were compared.Results The perineal body length,height,contraction amplitude,and Young's modulus value of the secondary multipara group in resting-state,and maximum contraction state were all reduced compared with those of the primipara group and the control group(P＜0.05).In the same state,the Young's modulus values and the difference of the levator ani muscle among the three groups was statistically significant(P＜0.05).In different states,the differences in Young's modulus values of the levator ani muscle between the control group and the primipara group were statistically significant(P＜0.05).Young's modulus of the levator ani muscle in maximum contraction state in the secondary multipara group was higher than that of resting-state and Vasalva state.There was no statistically significant difference in Young's modulus between the resting-state and valsalva state in the secondary multipara group(P＞0.05).Conclusions The near-term impacts of the second natural childbirth on perineal body and levator ani muscle function are more obvious than those of the first natural delivery.The two-dimensional gray scale ultrasound combined with the real-time shear wave elastography technique can assess the variability of the perineal body and the levator ani muscle function among different parity in natural childbirth.
Natural childbirthParityElasticity imaging techniquesPerineal bodylevator ani muscle
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