摘要
Abstract
Objective To study the recent effects of the duration of the second stage of labor on female pelvic floor function after new partogram applied.Methods A total of 174 nulliparous women were retrospectively analyzed,who accept epidural anesthesia in the duration of labor at our hospital from Jan.1,2016 to Dec.31,2016 (The new labor standard was used during this time).Women with multiple gestation,noncephalic presentations,induction of labor after fetal death,stress urinary incontinence,genital malformation and pelvic floor dysfunction were excluded.All these women have no obvious difference at internal and external complications,age,body mass index before pregnant,weight gained in the gestation period or neonatal weight.They were divided into 3 groups based on second-stage duration (t),34 women with 2 hours≤t＜2.5 hours in group A1,20 women with 2.5 hours≤t＜3 hours in group A2,and 20 women with t≥3 hours in group A3.Another 100 nulliparous women with t＜2 hours were included as the control group named group B.Questionnaires and pelvic organ prolapse quantification (POP-Q) and classification,stress urinary incontinence,pelvic floor comprehensive strength test were carried out 42 days after the delivery,so as to compare the effect of duration of the second stage of labor on female pelvic floor function.Results The point Aa(the point in the anterior vaginal wall,3cm from hymen),Ba (the point in the anterior vaginal prolapse,farthest from hymen),C (the point in the anterior fornix of vagina or vaginal stump),D (the point in the vaginal posterior fornix) and the length of perineal body (pb),toatal vaginal length (tvl) were compared among the four groups,and the differences were statistically significant (P＜0.05);further comparison between every two groups showed:the difference was statistically significant at point Aa,Ba,tvl,C and D between A3 and other group;the difference was statistically significant at pb between B,A1 and A2,A3 group;with regard to prolapse vaginae posterior in the pelvic organ prolapse classification,there was statistical difference between A3 and other groups;At stress urinary incontinence,the differences were statistically significant between the four groups;on pelvic floor comprehensive strength,there was statistical difference between A3 and other groups.Conclusion The duration of the second stage of labor has an effect on pelvic floor function.When the second stage of labor is greater than or equal to 3h,it will be the high risk factor for female pelvic floor dysfunction after delivery.So the progress of labor should be closely monitored,and the factors affecting labor should be dealt with in time to control the second stage of labor within 3 hours.关键词
初产妇/第二产程/盆底功能障碍性疾病Key words
nulliparous women/second stage of labor/pelvic floor dysfunction分类
医药卫生
