| 摘要: |
| 【摘要】目的 应用经会阴四维超声观察新生儿体重及不同的分娩方式引起盆底结构改变的图像特征。方法 对2016年5月至2016年12月在我院初产的产妇于产后第42天依照新生儿体重及分娩方式不同分：巨大新生儿自然分娩组40 例、巨大新生儿剖宫产组55 例，以及对照组：正常体重新生儿自然分娩组150 例、正常体重新生儿剖宫产组150 例（均初产，于产后第42天）均进行盆底超声检查，观察并记录静息、缩肛和Valsalva动作三个时态下膀胱颈、子宫颈、直肠肛管形态及活动度。四维图像重建后观察三个时态下肛提肌裂口形态及连续性，并测量肛提肌裂口面积，记录超声检查结果并与进行统计分析。结果 经自然分娩的巨大新生儿组与自然分娩正常新生儿组比较膀胱颈活动度和三个状态下的肛提肌裂口均明显增大，子宫下垂发病率也增加，而直肠膨出发病率和Valsalva状态下膀胱后角、膀胱颈倾斜角和膀胱颈旋转角均没有明显统计学差别。剖宫产 的巨大新生儿组与剖腹产的正常体重新生儿组比较仅膀胱颈活动度和膀胱颈旋转角增大，余各指标无统计学差别。巨大新生儿自然分娩组与剖宫产组比较，仅Valsalva状态下膀胱后角和直肠膨出发病率无统计学差异，余各指标均明显增大。结论 与正常体重新生儿组比较，巨大新生儿组对产妇盆底结构的近期影响较明显，尤其是自然分娩的巨大新生儿组。 |
| 关键词: 四维超声 巨大 新生儿 盆底 |
| DOI： |
| 投稿时间：2017-02-17修订日期：2017-12-29 |
| 基金项目:经会阴三维超声观察巨大胎儿妊娠和分娩对生殖裂孔和肛提肌肉功能的影响 |
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| Short-term effects of neonatal weight and different modes of delivery on maternal pelvic floor structure by perineum four-dimensional ultrasonography |
| xu ying zi |
| (Tongde hospital of zhejiang province) |
| Abstract: |
| Objective To observe the image features of pelvic floor structure changes in neonates by four-dimensional ultrasonography and different modes of delivery.Methods Data were collected from the patients in our hospital between May, 2016 to December, 2016. Maternal newborns were divided into three groups according to birth weight and delivery mode: the neonatal spontaneous delivery group (40 cases), giant newborn cesarean section group (55 cases) and the control groups of 150 cases of normal birth weight neonatal spontaneous delivery group or 150 cases of normal weight newborn cesarean section group (all primipara, 42 days postpartum). All the patients were underwent pelvic floor ultrasound examination to observe and record the rest, Anorectal and Valsalva action of three tense bladder neck, cervix, rectal anal canal morphology and activity. Four-dimensional images were reconstructed to observe the shape and continuity of the levator ani
muscle at three time points. The area of the levator ani muscle was measured, and the results of ultrasonography were recorded and analyzed statistically.Results There were significant increases in bladder neck mobility and the levator ani muscle rapture in the three groups. The incidence of uterine prolapse was also increased, while the incidence of rectal prolapse and the incidence of rectal prolapse were significantly higher than those of the normal neonates in natural childbirth Valsalva state of the bladder horn, bladder neck tilt angle and bladder neck rotation angle were not statistically significant difference. The caesarean section of the huge neonatal and caesarean section of the normal weight of newborns compared only bladder neck mobility and bladder neck rotation angle increased, the remaining indicators were not statistically significant. There were no significant differences in the incidence of posterior horn and rectum prolapse in the Valsalva state between the neonatal natural labor group and the cesarean section group.Conclusion Compared with the normal weight neonates, the neonatal group had a more obvious effect on the pelvic floor structure of the newborns, especially the huge neonatal group with spontaneous delivery. |
| Key words: Four-dimensional ultrasound Huge Neonatal Pelvic floor |
