CHEN Yu, SUN Congxin, WANG Weijing, GENG Xuna, WANG Pin, CHEN Guihong, ZHAO Wei, ZHANG Chunye.
Objective To explore the predictive value of observing the pelvic floor structure during pregnancy based on multimodal ultrasound for postpartum pelvic floor dysfunction (PFD). Methods Retrospective collection of data from 200 postpartum women who were registered, delivered, and followed up for 6 months in the Fourth Hospital of Shijiazhuang from January 2022 to April 2023. According to the incidence of PFD during the follow-up period, they were divided into an occurrence group (n=67) and a non occurrence group (n=133). The multimodal ultrasound parameters and other general information of pelvic floor structure were compared between two groups at different time points during pregnancy (10~12 weeks and 26~28 weeks). Logistic regression was used to analyze the effect of multimodal ultrasound parameters of pelvic floor structure on the occurrence of postpartum PFD. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of multimodal ultrasound parameters of pelvic floor structure for postpartum PFD. Results Compared with the non occurrence group, the distance from the bladder neck to the lower edge of the pubic symphysis (BSD) was smaller in the occurrence group at 26~28 weeks of gestation, and the posterior urethral angle (PUA), levator hiatus area (ALH) and the difference of BSD, PUA and ALH between 26~28 weeks of gestation and 10-12 weeks of gestation SBSD, SPUA and SALH were larger (P<0.05). The weight gain during pregnancy in the occurrence group was higher than that in the non occurrence group (P<0.05). Logistic regression analysis showed that ALH, SBSD, SPUA, SALH at 26~28 weeks of gestation and weight gain during pregnancy were all influencing factors of postpartum PFD (P<0.05). The results of ROC curve showed that the area under the curve of ALH, SPUA, SALH alone and combined with SBSD postpartum PFD at 26~28 weeks of gestation was>0.70, all of which had certain predictive value, and the combined predictive value was higher. Conclusion The multimodal ultrasound parameters BSD, PUA, ALH, and their changes can effectively reflect the changes in pelvic floor structure during pregnancy, which is beneficial for assisting clinical early prediction of postpartum PFD risk.
