Correlation between postpartum pelvic organ prolapse and anal sphincter hiatus area changes in women with dif-ferent modes of delivery and analysis of influencing factors
MA Li
CHEN Qi-zhen
CHEN Xiong
ZHU Jia-min
Abstract：Objective To explore the differences in anal sphincter hiatus area between vaginal and cesarean de-livery and its relationship with postpartum pelvic organ prolapse(POP).Methods Clinical data of 78 postpartum POP patients who visited Wusong Central Hospital of Baoshan District of Shanghai from January 2021 to January 2022 were se-lected.Among them,49 patients underwent vaginal delivery,designated as the POP vaginal delivery group,and 29 pa-tients underwent cesarean section,designated as the POP cesarean delivery group.Clinical data of 120 healthy parturients who underwent physical examination at our hospital during the same period were selected.Among them,75 had vaginal delivery,designated as the healthy vaginal delivery group,and 45 had cesarean section,designated as the healthy cesare-an delivery group.Retrospective analysis was performed on the clinical data of each group of study subjects.The anal sphincter hiatus area was compared in vaginal delivery women under different conditions and in cesarean delivery women under different conditions.Univariate analysis and logistic regression analysis were conducted to analyze the factors affect-ing POP occurrence in vaginal delivery women and cesarean delivery women.The correlation between anal sphincter hiatus area of POP patients and POP-Q stage was analyzed.Results In the POP vaginal delivery group,the anal sphincter hi-atus area in resting,Valsalva,and contraction states was significantly higher than that in the healthy vaginal delivery group(P＜0.05).In the POP cesarean delivery group,the anal sphincter hiatus area in resting,Valsalva,and contraction states was significantly higher than that in the healthy cesarean delivery group(P＜0.05).The proportion of parturients with gestational age ≥ 37 weeks and fetal weight＞4 kg in the POP vaginal delivery group was significantly higher than that in the healthy vaginal delivery group(P＜0.05).The proportion of parturients with vaginal trial labor in the POP ce-sarean delivery group was significantly higher than that in the healthy cesarean delivery group(P＜0.05).Gestational age and fetal weight were influencing factors for POP in vaginal delivery women(P＜0.05),while vaginal trial labor was an influencing factor for POP in cesarean delivery women(P＜0.05).POP-Q stages of the POP patients were as follows:Stage Ⅰ,32 cases;Stage Ⅱ,29 cases;Stage Ⅲ,17 cases.The anal sphincter hiatus area in resting,Valsalva,and contraction states was positively correlated with POP-Q stage(r=0.414,0.617,and 0.345,respectively,P＜0.05).Conclusion Monitoring anal sphincter hiatus area has good value in POP assessment.Women with vaginal delivery with gestational age ≥37 weeks and fetal weight＞4 kg are more prone to POP.Women with cesarean delivery who undergo vaginal trial labor are more prone to POP.Clinicians should pay close attention to relevant parturients,provide active edu-cation,and implement effective interventions to reduce the occurrence of POP.
Keywords：vaginal deliverycesarean sectionarea of hiatus of levator ani musclepelvic organ prolapse
Publication Date：2024-09-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1154-1159 )