Analysis of early postpartum pelvic floor electromyography and muscle strength in different modes of delivery

HU Qing; ZHANG Yu; XIA Zhi-jun; LIU Dan

doi:10.19538/j.fk2017120118

Abstract：Objective To explore the correlation between different delivery modes and the changes of postpartum pelvic floor electromyography as well as muscle strength.Methods A total of 329 cases meeting the inclusion and exclusion criteria were included as the research objects in the study who received antenatal examination during 36-38 weeks of gestation in Shengjing Hospital of China Medical University and were tested pelvic floor function in the treatment center from January,2014 to January,2015.They were divided into elective cesarean section group (162 cases)and vaginal delivery group (167 cases)according to the different modes of delivery,and the latter was divided into episiotomy group (84 cases) and non-episiotomy group (83 cases).All objects were instructed to measure the pelvic floor electromyography and class Ⅰ,Ⅱ type muscle strength for 4 times:at the period of antepartum,6 weeks,3 months and 5 months postpartum respectively.Results By comparing elective caesarean section group with the vaginal delivery group,episiotomy group with non-episiotomy group,the antepartal pelvic floor electromyography,muscle strength and some general situation had no statistically significant differences (P ＞ 0.05).For elective caesarean section group and the vaginal delivery group,except for energy value in 6 weeks postpartum,there were significant differences (P ＜ 0.05) at other time points,and the results of pelvic floor electromyography in cesarean section group were significantly higher than those in vaginal delivery group.For episiotomy group and non-episiot omy group,the differences of all at the period of 6 weeks,3 months and 5 months postpartum had no statistical significance (P ＞ 0.05).At the period of 6 weeks,3 months and 5 months postpartum,in elective caesarean group,type Ⅰ muscle strength decreased 32.26％,35.48％ and 27.42％,and type Ⅱ muscle strength decreased 61.29％,54.84％ and 46.77％.In vaginal delivery group,type Ⅰ muscle strength decreased 41.79％,52.24％ and 46.27％,and type Ⅱ muscle strength decreased 71.64％,70.15％ and 62.69％.In episiotomy group,type Ⅰ muscle strength decreased 41.17％,52.94％ and 44.12％,and type Ⅱ muscle strength decreased 79.41％,76.47％ and 52.94％.In non-episiotomy group,type Ⅰ muscle strength decreased 42.42％,51.52 and 39.39％,and type Ⅱ muscle strength decreased 63.64％,63.64％ and 51.52％.Therefore,whether in the cesarean section group and vaginal delivery group,or episiotomy group and nonepisiotomy group,the incidences of pelvic floor class Ⅰ,Ⅱ type muscle strength decline was not significantly different (P ＞ 0.05).Conclusion The impact of elective cesarean section on the early postpartum pelvic floor electromyography is less than the vaginal delivery.However,there is no difference in pelvic floor muscle strength between these two groups.Episiotomy cannot reduce the effect of postpartum pelvic floor function.Pelvic floor electromyography and muscle strength may not be synchronized for the evaluation of early postpartum pelvic floor function.