Value of three-dimensional ultrasound and real-time shear wave elastography in the assessment of postpartum pelvic floor functional changes and stress urinary incontinence in primiparous women following different delivery modes
WU Yulin
LI Jie
SHEN Xianghui
ZHANG Yixin
ZHANG Qiang
Abstract：Objective To investigate the value of three-dimensional(3D)ultrasound and real-time shear wave elastography(SWE)in the assessment of postpartum pelvic floor functional changes and stress urinary incontinence(SUI)in primiparous women following different delivery modes.Methods A total of 250 primiparous women who underwent postpartum check-ups at 6-8 weeks after delivery from October 2023 to October 2024 were selected.They were divided into a vaginal delivery group(n=146)and a cesarean section group(n=104)according to the delivery mode.All participants underwent 3D pelvic floor ultrasound and real-time SWE and completed SUI-related questionnaires.Differences in ultrasound structural parameters(levator hiatal area,and bladder neck descent)and functional parameters(Young's modulus of the urethral sphincter and puborectalis muscle)were compared between the two groups,and risk factors for postpartum SUI occurrence were analyzed.Results The levator hiatal area was significantly larger,and the Young's modulus values of the urethral sphincter were significantly lower in the vaginal delivery group compared with the cesarean section group(P＜0.05).The incidence of SUI in the vaginal delivery group(29.45％,43/146)was significantly higher than that in the cesarean section group(10.58％,11/104)(P＜0.01).Multivariate logistic regression analysis showed that the Valsalva levator hiatal area,delivery mode,neonatal body weight,duration of the second stage of labor,and instrumental delivery were all independent risk factors for postpartum SUI(P＜0.05);the Young's modulus of the urethral sphincter at the posterior lip at rest was a protective factor(P＜0.05).Conclusion 3D ultrasound and real-time SWE indicators(such as the Valsalva levator hiatal area and Young's modulus of the urethral sphincter)as well as obstetric-related factors(pre-pregnancy body mass index,neonatal body weight,duration of the second stage of labor,and delivery mode)are significantly correlated with the occurrence of postpartum SUI.This suggests that combining imaging indicators with obstetric-related factors can help identify high-risk populations for postpartum SUI.
Keywords：three-dimensional ultrasoundreal-time shear wave elastographyprimiparous womenpelvic floor functionstress urinary incontinencelevator hiatal areaYoung's modulus of the urethral sphincter
Publication Date：2025-12-28
Online Publishing Date：2026-01-16(First online date of this platform, not the publication date of the document)
Pages：6( 105-110 )