Shaohui Chen, Ling Wang, Huitao Guo, Min Jiang, Xiaojun Wang
{"title":"产后盆底肌肉损伤的比较分析:阴道分娩与剖腹产","authors":"Shaohui Chen, Ling Wang, Huitao Guo, Min Jiang, Xiaojun Wang","doi":"10.1155/2024/1169924","DOIUrl":null,"url":null,"abstract":"<div>\n <p><i>Background</i>. Evaluation of pelvic floor muscle (PFM) strength damage across different delivery modes, providing insights into potential preventive measures for pelvic floor dysfunctions (PFDs) in the early postpartum period. <i>Aim</i>. Compare the differences in PFM strength and endurance between full-term cesarean section (CS) and vaginal delivery (VD) in the early postpartum period of primiparous women. <i>Methods</i>. The assessment included stress urinary incontinence (SUI), pelvic organ prolapse (POP), and pelvic floor electromyography (PFE). Muscle fiber strength was categorized into four modes at a threshold level of 3: I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3. Multinomial logistic regression was employed for CS and VD, and a sensitivity analysis was conducted using level 2 as the threshold. <i>Outcomes</i>. When muscle fiber strength was categorized into four modes at a threshold level of 3, Type I, and Type II fiber muscle endurance (FME) are differences between the CS and VD groups. <i>Results</i>. The CS and VD groups differed significantly in SUI and anterior and posterior vaginal wall conditions. MDVP was below the normal range in both groups, and MDVP, PFM strength, and PFM endurance did not differ significantly (<i>P</i> > 0.05). Logistic regression results indicated that higher MDVP, Type I, and Type II FME were protective factors when I < 3 in the VD group. However, I < 3-II > 3, higher MDVP, and Type I FME were protective factors (OR: 0.339, 95% CI: 0.223, 0.516) in the CS group. <i>Clinical Implications</i>. The study introduces a nuanced understanding of the impact of different delivery modes on PFM, contributing valuable insights for clinical prevention and treatment strategies in the early postpartum period. <i>Strengths and Limitations</i>. Muscle fiber strength was categorized into four modes and further sensitivity analysis was conducted. This study only conducted a correlation analysis of outcome variables without considering intervenable variables. <i>Conclusions</i>. The VD group had a higher incidence of pelvic floor dysfunction in the early postpartum period than the CS group. Both groups experienced a decline in PFM function without significant differences. CS was primarily associated with Type I muscle fiber damage, while VD was related to both Type I and II muscle fiber damage. Improving PFM endurance is beneficial for muscle strength recovery.</p>\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1169924","citationCount":"0","resultStr":"{\"title\":\"Comparative Analysis of Pelvic Floor Muscle Damage Postpartum: Vaginal Delivery vs. Cesarean Section\",\"authors\":\"Shaohui Chen, Ling Wang, Huitao Guo, Min Jiang, Xiaojun Wang\",\"doi\":\"10.1155/2024/1169924\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><i>Background</i>. Evaluation of pelvic floor muscle (PFM) strength damage across different delivery modes, providing insights into potential preventive measures for pelvic floor dysfunctions (PFDs) in the early postpartum period. <i>Aim</i>. Compare the differences in PFM strength and endurance between full-term cesarean section (CS) and vaginal delivery (VD) in the early postpartum period of primiparous women. <i>Methods</i>. The assessment included stress urinary incontinence (SUI), pelvic organ prolapse (POP), and pelvic floor electromyography (PFE). Muscle fiber strength was categorized into four modes at a threshold level of 3: I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3. Multinomial logistic regression was employed for CS and VD, and a sensitivity analysis was conducted using level 2 as the threshold. <i>Outcomes</i>. When muscle fiber strength was categorized into four modes at a threshold level of 3, Type I, and Type II fiber muscle endurance (FME) are differences between the CS and VD groups. <i>Results</i>. The CS and VD groups differed significantly in SUI and anterior and posterior vaginal wall conditions. MDVP was below the normal range in both groups, and MDVP, PFM strength, and PFM endurance did not differ significantly (<i>P</i> > 0.05). Logistic regression results indicated that higher MDVP, Type I, and Type II FME were protective factors when I < 3 in the VD group. However, I < 3-II > 3, higher MDVP, and Type I FME were protective factors (OR: 0.339, 95% CI: 0.223, 0.516) in the CS group. <i>Clinical Implications</i>. The study introduces a nuanced understanding of the impact of different delivery modes on PFM, contributing valuable insights for clinical prevention and treatment strategies in the early postpartum period. <i>Strengths and Limitations</i>. Muscle fiber strength was categorized into four modes and further sensitivity analysis was conducted. This study only conducted a correlation analysis of outcome variables without considering intervenable variables. <i>Conclusions</i>. The VD group had a higher incidence of pelvic floor dysfunction in the early postpartum period than the CS group. Both groups experienced a decline in PFM function without significant differences. CS was primarily associated with Type I muscle fiber damage, while VD was related to both Type I and II muscle fiber damage. 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引用次数: 0
摘要
背景。评估不同分娩方式对盆底肌肉(PFM)力量的损伤,为产后早期盆底功能障碍(PFDs)的潜在预防措施提供洞察力。目的比较足月剖宫产(CS)和阴道分娩(VD)在初产妇产后早期盆底肌力量和耐力方面的差异。方法。评估包括压力性尿失禁(SUI)、盆腔器官脱垂(POP)和盆底肌电图(PFE)。肌肉纤维强度在阈值为 3 时分为四种模式:I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3。对 CS 和 VD 采用了多项式逻辑回归,并以 2 级为临界值进行了敏感性分析。结果。在阈值为 3 时,将肌纤维强度分为四种模式,I 型和 II 型纤维肌耐力(FME)在 CS 组和 VD 组之间存在差异。结果。CS 组和 VD 组在 SUI 和阴道前后壁条件方面差异显著。两组的 MDVP 均低于正常范围,MDVP、PFM 强度和 PFM 耐力无显著差异(P >0.05)。逻辑回归结果表明,当 VD 组的 I < 3 时,较高的 MDVP、I 型和 II 型 FME 是保护因素。然而,在 CS 组中,I < 3-II > 3、较高的 MDVP 和 I 型 FME 是保护因素(OR:0.339,95% CI:0.223,0.516)。临床意义。该研究让人们对不同分娩方式对 PFM 的影响有了细致入微的了解,为产后早期的临床预防和治疗策略提供了有价值的见解。优势和局限。肌肉纤维强度分为四种模式,并进行了进一步的敏感性分析。本研究仅对结果变量进行了相关性分析,未考虑可干预变量。结论VD组产后早期盆底功能障碍的发生率高于CS组。两组的盆底肌功能都有所下降,但无显著差异。CS 主要与 I 型肌纤维损伤有关,而 VD 则与 I 型和 II 型肌纤维损伤有关。提高 PFM 的耐力有利于肌肉力量的恢复。
Comparative Analysis of Pelvic Floor Muscle Damage Postpartum: Vaginal Delivery vs. Cesarean Section
Background. Evaluation of pelvic floor muscle (PFM) strength damage across different delivery modes, providing insights into potential preventive measures for pelvic floor dysfunctions (PFDs) in the early postpartum period. Aim. Compare the differences in PFM strength and endurance between full-term cesarean section (CS) and vaginal delivery (VD) in the early postpartum period of primiparous women. Methods. The assessment included stress urinary incontinence (SUI), pelvic organ prolapse (POP), and pelvic floor electromyography (PFE). Muscle fiber strength was categorized into four modes at a threshold level of 3: I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3. Multinomial logistic regression was employed for CS and VD, and a sensitivity analysis was conducted using level 2 as the threshold. Outcomes. When muscle fiber strength was categorized into four modes at a threshold level of 3, Type I, and Type II fiber muscle endurance (FME) are differences between the CS and VD groups. Results. The CS and VD groups differed significantly in SUI and anterior and posterior vaginal wall conditions. MDVP was below the normal range in both groups, and MDVP, PFM strength, and PFM endurance did not differ significantly (P > 0.05). Logistic regression results indicated that higher MDVP, Type I, and Type II FME were protective factors when I < 3 in the VD group. However, I < 3-II > 3, higher MDVP, and Type I FME were protective factors (OR: 0.339, 95% CI: 0.223, 0.516) in the CS group. Clinical Implications. The study introduces a nuanced understanding of the impact of different delivery modes on PFM, contributing valuable insights for clinical prevention and treatment strategies in the early postpartum period. Strengths and Limitations. Muscle fiber strength was categorized into four modes and further sensitivity analysis was conducted. This study only conducted a correlation analysis of outcome variables without considering intervenable variables. Conclusions. The VD group had a higher incidence of pelvic floor dysfunction in the early postpartum period than the CS group. Both groups experienced a decline in PFM function without significant differences. CS was primarily associated with Type I muscle fiber damage, while VD was related to both Type I and II muscle fiber damage. Improving PFM endurance is beneficial for muscle strength recovery.
期刊介绍:
IJCP is a general medical journal. IJCP gives special priority to work that has international appeal.
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