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目的探讨胎儿体质量对经阴道分娩初产妇肛提肌形态与功能的影响。方法选择单胎经阴道分娩初产妇80例,根据新生儿出生时体质量分成产后正常体质量儿组和产后巨大儿组。应用断层超声、经会阴二维及三维超声观察肛提肌的形态及损伤情况。结果产后巨大儿组初产妇肛提肌损伤的发生率[56.00%(14/25)]明显高于产后正常体质量儿组[18.18%(10/55)],差异有统计学意义(2χ=11.706,P=0.001)。产后巨大儿组肛提肌裂孔长度、面积大于产后正常体质量儿组,肛提肌裂孔水平成角小于产后正常体质量儿组,均有统计学差异(P<0.05)。结论联合断层、二维、三维超声可有效评价胎儿体质量对阴道分娩初产妇肛提肌的影响。妊娠和分娩巨大儿更易造成产妇肛提肌的损伤及功能的改变。
Objective To investigate the effects of fetal body mass on the morphology and function of levator ani muscle during vaginal delivery. Methods 80 cases of primiparous single child born by vaginal delivery were divided into normal weight group and postnatal gigantic group according to their weight at birth. Application of tomographic ultrasound, the perineal two-dimensional and three-dimensional ultrasound levator ani muscle morphology and injury. Results The incidence of levator ani muscle injury in the postnatal gigantic group was significantly higher than that in the postnatal normal weight group [56.18% (14/25) [18.18% (10/55)], with significant difference (2χ = 11.706, P = 0.001). The length and area of the levator ani muscle lobule in the postpartum giant children group were larger than those in the normal postnatal normal weight group, and the levator ani muscle lobe level was smaller than that in the normal postnatal weight group (P <0.05). Conclusions Combined tomography, two-dimensional and three-dimensional ultrasonography can effectively evaluate the effects of fetal weight on levator ani in vaginal delivery. Giant pregnancy and childbirth more likely to cause maternal levator ani muscle damage and changes in function.