在阴道分娩和剖腹产后使用剪切波弹性学评估levator ani肌肉弹性和剖腹产
Yoshiyuki Okada1,2, Chie Nakagawa3,4, Miwa Shigeta3
1Department of Female Pelvic Health Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-Ku, Yokohama City, Kanagawa, 224-8503, Japan. yokada@med.showa-u.ac.jp.
Journal of medical ultrasonics (2001)
|September 23, 2023
概括
与剖腹产相比,阴道分娩与较低的上升肌肉 (LAM) 弹性有关. 手术性阴道分娩进一步降低了右侧腹部的弹性,突出了产后盆底评估的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 盆地地板成像技术 盆地地板成像技术
- 肌肉骨超声波 肌肉骨超声波
背景情况:
- 盆地肌肉损伤是分娩后的一个担忧.
- 阴道分娩通常被认为比剖腹产带来更高的盆地肌肉损伤风险.
- 客观地评估产后的升高肌肉 (LAM) 弹性对于理解恢复至关重要.
研究的目的:
- 为了比较通过阴道分娩和剖腹产分娩的妇女之间的升高肌肉 (LAM) 的弹性.
- 为了评估LAM弹性使用剪波弹性学 (SWE) 产后一个月.
- 根据分娩类型,在阴道分娩组内进行LAM弹性的子组分析.
主要方法:
- 一项前性研究,涉及产后妇女,她们在第一次分娩后一个月接受一次SWE评估.
- 参与者被分为阴道分娩和剖腹产分娩组.
- 测量了右侧和左侧LAM的弹性模块,并在组之间进行了比较,并对正常的阴道,表皮切割和手术性阴道分娩进行了子组分析.
主要成果:
- 包括62名妇女:47例阴道分娩和15例剖腹产.
- 与剖腹产相比,阴道分娩与明显较低的LAM弹性模量有关 (右侧LAM:44.2比72.7kPa;左侧LAM:40.4比82.7kPa).
- 手术性阴道分娩显示右侧LAM弹性明显低于正常阴道分娩 (p=0.0131),而阴道分娩子组中左侧LAM弹性没有显著差异.
结论:
- 与剖腹产相比,阴道分娩后,部肌肉 (LAM) 的弹性显著降低.
- 与正常的阴道分娩相比,手术性阴道分娩与右侧LAM弹性降低有关.
- 剪波弹性图 (SWE) 为客观,定量评估产后盆底肌肉恢复提供了一个有价值的工具.
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