15 November 2025, Volume 26 Issue 6

    

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  Advances in diagnosis and treatment of vaginal relaxation syndrome and related issues#br#

  MEN Yuqi, SUN Xiuli.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 481-482. https://doi.org/10.13390/j.issn.1672-1861.2025.06.001

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  Analysis of mid-term outcomes of extraperitoneal high uterosacral ligament suspension surgery in the treatment of pelvic organ prolapse and lower urinary tract symptoms

  SUN Xiaohui, SONG Jiaoyang, WEI Xiaoting, YU Xiaojie, WANG Shiyan, SUN Xiuli.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 483-486. https://doi.org/10.13390/j.issn.1672-1861.2025.06.002

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  Objective To evaluate whether pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS) can be improved by extraperitoneal high uterosacral ligament suspension (EHUS). Methods The clinical data of patients who visited Peking University People's Hospital due to POP and underwent EHUS from January to September 2021 were retrospectively collected. The patients were followed up before surgery, 1 month after surgery, 6 months after surgery, and 12 months after surgery. The POP-Q score was used to evaluate the postoperative anatomical repositioning effect of the patients, the overactive bladder symptom score questionnaire (OABSS) was used to evaluate the improvement of LUTS after surgery, and the pelvic floor dysfunction inventory-20 (PFDI-20) was used to evaluate the improvement of quality of life after surgery. Results Twelve months after EHUS, the location of POP-Q points was significantly higher than preoperative location (P<0.001). Twelve months after EHUS, the median OABSS score was 1 (0, 2) and the median PFDI-20 score was 0.00 (0.00, 0.83), both significantly lower than the preoperative scores (P<0.05). Conclusions EHUS can improve LUTS and quality of life in patients with POP while achieving anatomical restoration.
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  Clinical study of progressive stepwise training combined with neuromuscular electrical stimulation in the treatment of postpartum diastasis recti abdominis

  WANG Lingling, CHEN Minghua, HUANG Huiping, ZHU Yanhua, MA Rui, XU Jing.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 487-490. https://doi.org/10.13390/j.issn.1672-1861.2025.06.003

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  Objective To investigate the clinical therapeutic effects of progressive step training combined with neuromuscular electrical stimulation (NMES) on postpartum patients with diastasis recti abdominis (DRA). Methods A total of 100 patients with DRA were prospectively enrolled and randomly assigned into two groups using a randomly divided into the control group (NMES only) and the observation group (NMES combined with progressive stepwise training), with 50 patients in each group. The treatment period lasted 5 weeks. Changes in inter-rectus distance (IRD), abdominal muscle strength, and lower back pain (assessed by VAS score) were compared before and after treatment. Results The total effective rate in the observation group was 97.9%, significantly higher than that in the control group (89.8%, P<0.01). Both groups showed significant post-treatment improvements in inter-rectus distance, muscle strength scores, and VAS scores compared with baseline (P<0.05), with the observation group demonstrating greater improvement than the control group (P<0.05). No serious adverse events occurred during the treatment period. A few of patients experienced mild skin tingling or transient muscle soreness, which were well tolerated. Conclusions Progressive stepwise training combined with NMES can effectively reduce inter-rectus distance, enhance abdominal muscle strength, and relieve lower back pain, and has clinical application value.
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  Clinical study on synchronized rehabilitation of postpartum diastasis recti abdominis combined with pelvic floor muscle strength less than grade 3

  ZAHNG Li, WANG Li, HU Guoyun, GUO Ziyi, HU Huiwen.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 491-494. https://doi.org/10.13390/j.issn.1672-1861.2025.06.004

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  Objective To compare the clinical efficacy of single pelvic floor rehabilitation versus synchronous recti abdominis combined with pelvic floor rehabilitation in postpartum patients with diastasis recti abdominis (DRA) and pelvic floor muscle strength less than grade 3. Methods A total of 96 primiparous women diagnosed with DRA and weakened pelvic floor muscle strength during 42-day postpartum examination at Changzhou Maternal and Child Health Care Hospital from January 2023 to January 2024 were selected, computer-generated random number table method was used to randomly divided into single pelvic floor rehabilitation group (single pelvic floor rehabilitation group) and combined group(synchronous recti abdominis rehabilitation combined with pelvic floor rehabilitation group). Both groups underwent one treatment course (10 sessions), and statistical analysis was performed to compare the differences in therapeutic effects between the two groups. Results Both groups showed improvements in pelvic floor muscle strength (deep and superficial muscles) and Pelvic Organ Prolapse Quantification (POP-Q) (Aa, Ba, C, D) indicators before and after treatment, with statistically significant differences (P＜0.05). However, no statistically significant between-group differences were observed in terms of pelvic floor muscle strength grade (deep and superficial muscles) or POP-Q (Aa, Ba, C, D, Ap, Bp, TVL) before and after treatment (P＞0.05). Conclusions Synchronous rehabilitation for postpartum DRA combined with pelvic floor muscle strength less than grade 3 is effective, safe, and is conducive to promoting early postpartum recovery.
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  Characteristic analysis of motor evoked potential induced by magnetic stimulation of sacral nerve in patients with pelvic organ prolapse

  SONG Jiaoyang, ZHU Hongmei, YANG Yang, WANG Shiyan, SUN Xiuli.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 495-499. https://doi.org/10.13390/j.issn.1672-1861.2025.06.005

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  Objective By comparing the latency and amplitude differences of sacral nerve magnetic stimulation evoked potentials between patients with pelvic organ prolapse (POP) and those without POP, this study aims to investigate whether pelvic floor nerve conduction dysfunction exists in patients with POP. Methods Fifty-five patients with POP who visited Peking University People's Hospital from October 2024 to January 2025 (POP group) and 52 patients with non-POP who visited due to benign diseases during the same period (control group) were selected. Both groups of patients underwent sacral nerve magnetic stimulation motor evoked potential examination. The differences in latency and amplitude of motor evoked potentials between the two groups were compared, and the influencing factors of motor evoked potentials in patients with pelvic floor organ prolapse were analyzed. Results Compared with the control group, the latency of the sacral nerve magnetic stimulation motor evoked potential in the POP group was significantly prolonged [(7.50±3.49) ms, (5.11±3.49) ms; P<0.001], and there was no significant difference in wave amplitude between the two groups [(69.55±33.21) uV, (76.70±33.21) uV, P=0.339]; The weakening of pelvic floor muscle strength was significantly correlated with the prolonged latency of magnetic stimulation motor evoked potentials (P=0.014). Conclusions Patients with POP have significantly slower latency of motor evoked potentials induced by sacral nerve magnetic stimulation compared to POP patients, suggesting that POP patients may have pelvic nerve damage. This examination is expected to become a non-invasive electrophysiological indicator for evaluating pelvic nerve function of POP patients.
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  Application of balloon expulsion test in the evaluation of defecation symptoms in patients with pelvic organ prolapse

  LIU Yanhua, TAN Man, TAN Cheng, YANG Xin.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 500-503. https://doi.org/10.13390/j.issn.1672-1861.2025.06.006

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  Objective To evaluate defecation symptoms in women with pelvic organ prolapse (POP) and to discuss the application of the balloon expulsion test (BET) as an objective indicator in the evaluation of posterior POP. Methods A total of 214 patients with POP treated in Peking University People's Hospital from October 2019 to January 2021 were collected. All patients underwent the BET. We analyzed the relation between BET time and the severity of POP, and compared BET and desire to defecate volume (DDV) BET in defecation symptoms. Results (1) The median BET time of the stage 0Ⅰ group was 18.80 (7.65, 36.75) s, and the median BET time of the stage Ⅱ-Ⅳ group was 22.00s (11.15s, 55.25s). There was no statistically significant difference between BET time and posterior POP (P=0.094). There was a significant difference in constipation scoring system (CSS) scores between the two groups (P=0.014). (2) The area under the curve (AUC) of assistance in defecation was 0.6484 (95%CI 0.5629~0.7339), specificity was 83.2%, and negative predictive value was 80.7%. The AUC of the duration of constipation was 0.6405 (95%CI 0.5602~0.7207), the specificity was 86.0%, and the negative predictive value was 74.1%. (3) 64.0% (16/25) of the patients failed to expel the 50 ml balloon, but they could successfully expel the DDV balloon. Conclusions BET was associated with defecation symptoms in the POP population, but not with prolapse severity. BET and DDV BET have certain screening value for POP patients in assessing whether they need assistance in defecation and the assessment of the duration of constipation in POP patients.
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  The value of transperineal three-dimensional pelvic floor ultrasound in the evaluation of female stress urinary incontinence using the posterior angle of the bladder and urethra under maximum Valsalva maneuver

  LI Qian, MOU Ruixue, ZHOU Huili.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 504-507. https://doi.org/10.13390/j.issn.1672-1861.2025.06.007

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  Objective To explore the value of the posterior urethrovesical angle (PUVA) under maximum Valsalva maneuver measured by transperineal three-dimensional pelvic floor ultrasound in evaluating female stress urinary incontinence (SUI). Methods A total of 68 SUI patients admitted from June 2021 to May 2023 were selected as the study group, and another 68 subjects who underwent normal health checkups during the same period were chosen as the control group. Both groups underwent transperineal three-dimensional pelvic floor ultrasound examination to measure the PUVA, levator hiatus area (LHA), and bladder neck descent (BND) under maximum Valsalva maneuver. The relationships between these indicators and the severity of SUI, as well as their evaluation value for female SUI, were analyzed. Results The PUVA, LHA, and BND under maximum Valsalva maneuver in the study group were all higher than those in the control group (P<0.05). For patients with extremely severe SUI, the PUVA, LHA, and BND under maximum Valsalva maneuver were sequentially higher than those with severe, moderate, and mild SUI (P<0.05). The Kendall's tau-b correlation coefficient test showed that the severity of SUI in patients was positively correlated with the PUVA, LHA, and BND under maximum Valsalva maneuver (r>0, P<0.05). ROC curve analysis revealed that the area under the curve (AUC) for diagnosing SUI by single detection of PUVA, LHA, BND under maximum Valsalva maneuver, as well as their combined detection, were all>0.70, among which the combined detection had higher diagnostic value. Conclusions The PUVA, LHA, and BND under maximum Valsalva maneuver measured by transperineal three-dimensional pelvic floor ultrasound are associated with SUI and have certain diagnostic value for SUI.
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  Clinical treatment and prognostic analysis of patients with secondary pelvic metastases from gynecological malignant tumors (with clinical analysis of 29 cases)

  ZHANG Hui, ZHANG Huanzhi, WANG Qi, TANG Xiaodong, GUO Wei, WANG Jianliu, LI Xiaoping.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 508-512. https://doi.org/10.13390/j.issn.1672-1861.2025.06.008

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  Objective To analyze the clinical characteristics and treatment methods of patients with secondary pelvic metastases from gynecological malignancies, and to investigate prognostic factors. Methods Clinical data were collected from 29 patients with pelvic metastases from gynecologic malignancies admitted to Peking University People's Hospital between June 2010 and January 2025. Follow-up assessments included NRS pain grading, KPS functional status scores, postoperative MSTS-93 scores and survival status. Results All cases were followed up. All patients underwent systemic treatments, including 5 patients were treated with radiotherapy and 7 patients underwent surgical treatment. Additionally, patients who underwent pelvic reconstruction with 3D printed prostheses (4 cases) had significantly higher postoperative MSTS-93 scores than those who underwent reconstruction by other methods (P<0.05). The median survival time for these patients was 20.0 months (5.9~34.1 months). Multivariate Cox proportional hazards regression analysis showed that histological gradesⅡ&Ⅲ, non-primary pelvic metastasis, and bilateral pelvic metastasis were risk factors for patient prognosis, while asynchronous pelvic metastasis and comprehensive treatment were protective factors (all P<0.05). Conclusions Patients with gynecologic malignancies secondary to pelvic metastases have poor quality of life and unfavorable survival prognosis. The effect of 3D printed pelvic reconstruction on survival was not statistically significant; however, precise prosthetic design, strict surgical procedures, and reasonable postoperative management can improve patients' quality of life.
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  Clinical study on PGRMC1 expression predicting treatment response in fertility-preserving therapy for endometrial carcinoma

  WANG Na, ZHANG Xiaobo, WANG Yiqin, SHEN Xiaoyan, SHEN Danhua, WANG Jianliu.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 513-516. https://doi.org/10.13390/j.issn.1672-1861.2025.06.009

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  Objective To evaluate progesterone receptor membrane component 1 (PGRMC1) as a potential biomarker for predicting fertility-sparing treatment outcomes in endometrial cancer (EC). Methods Immunohistochemistry (two-step method) was performed to analyze PGRMC1 expression patterns in EC tissues before treatment, at 3-6 months during treatment, and within 3 months after complete remission (CR). Correlations with estrogen receptor (ER), progesterone receptor (PR), and Ki-67 were assessed. UALCAN and CPTAC databases were used for validation. Results PGRMC1 showed strong positivity in EC tissues, and the expression decreased after remission [2.70 (2.25, 2.85) vs 1.00 (1.00, 2.10), P=0.002]. Positive correlation with PR was observed (r=0.66, P=0.01). Database analysis revealed that high PGRMC1 expression predicted worse overall survival in EC patients, consistent across stageⅠand low-grade subgroups (all P<0.05). Conclusions PGRMC1 expression is closely related to EC prognosis and progesterone treatment efficacy; its dynamic decrease may be a potential predictive marker.
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  Analysis of clinical characteristics of 130 cases of postmenopausal ovarian endometriosis

  LU Xinlei, LAI Jin, ZHU Honglan.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 517-520. https://doi.org/10.13390/j.issn.1672-1861.2025.06.010

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  Objective To analyze the clinical characteristics and surgical management of postmenopausal ovarian endometriosis, exploring its pathogenesis and malignant potential. Methods Retrospective analysis of 130 postmenopausal patients with ovarian endometriosis who underwent surgery at Peking University People's Hospital (Jan 2014 - Aug 2023) were retrospectively analyzed, with surgical outcomes and clinical features evaluated. Results Among the 130 patients, the mean age of (58.36±5.66) years, with a mean menopausal age of (49.6±5.18) years. Postoperative pathology confirmed ovarian endometriomas in 69.23% (90/130) of cases, while 16.92% (22/130) exhibited malignant transformation. The malignancy rates were 35.71% (20/56) for cysts>4 cm and 73.68% (14/19) for those >10cm. Patients with elevated CA125 (>35 U/mL) showed a 44.44% (12/27) malignancy rate. Conclusions Asymptomatic postmenopausal ovarian endometriomas ≤4 cm may be monitored. Persistent cysts>4 cm warrant surgery. Cysts>10 cm or with elevated tumor markers require MRI evaluation for malignancy risk, with cautious selection of approach and scope.
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  Status of high-risk HPV infection in cervical cancer screening among Tibetan women in Shannan Prefecture, Tibet Autonomous Region

  ZHANG Lufang, Yeshe Lhamo, ZHAO Qin, SHEN Yi.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 521-525. https://doi.org/10.13390/j.issn.1672-1861.2025.06.011

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  Objective To understand the infection status of high-risk human papillomavirus (HR-HPV) among Tibetan women in Shannan, Tibet and its application value in the screening and diagnosis of cervical precancerous lesions. Methods A total of 78996 Tibetan women aged 16~81 years who underwent free cervical cancer screening between January 2019 to June 2024 were enrolled. All participants received HR-HPV genotyping and liquid-based cytology testing (LCT). Individuals positive for HPV 16/18, those with atypical squamous cells of undetermined significance (ASCUS) combined with other HR-HPV types, or those with LCT results≥ASCUS were referred for colposcopy and biopsy. Patterns of HR-HPV infection and cervical intraepithelial lesions were analyzed. Results The overall HR-HPV infection rate was 7.3% (5 766/78 996), with HPV16/18 accounting for 19.1% (1 101/5 766). The highest infection rate was observed in women aged 40~49 years (8.0%, 1 605/20 065), showing statistically significant differences compared with other age groups (P=0.004). The detection rate of cervical cancer and precancerous lesions was 429.5 per 100 000 (339/78 996), among which high-grade squamous intraepithelial lesions (HSIL) accounted for 63.9% (131/206). And the HPV 16/18 positivity rate among HSIL cases was 60.5% (205/339). The sensitivity of colposcopy for diagnosing low-grade squamous intraepithelial lesions (LSIL) was 85.0% (638/751), and for HSIL was 61.8% (55/89). Multivariate analysis identified urban residence and multiple sexual partners were independent risk factors for HR-HPV infection. Conclusions The prevalence of HR-HPV infection among Tibetan women in Shannan varies significantly by age and region, with HPV 16/18 being predominant in HSIL cases. Targeted screening should be enhanced for urban women aged 40~49 and those with multiple sexual partners. In postmenopausal women with typeⅢtransformation zones, endocervical curettage should be supplemented to improve diagnostic accuracy. Especially when the lesions inside the cervical canal cannot be fully exposed or evaluated under colposcopy, to reduce the risk of missed diagnosis of high-grade lesions, and thus improve the overall reliability of cervical lesion diagnosis.
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  Curative effect of transcervical resection of polyp combined with levonorgestrel-releasing intrauterine system and its influences on recurrence

  ZHOU Yue, FU Xuemei, ZHANG Lin, SONG Li, KANG Shufang.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 526-529. https://doi.org/10.13390/j.issn.1672-1861.2025.06.012

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  Objective To explore the curative efficacy of transcervical resection of polyp (TCRP) combined with levonorgestrel-releasing intrauterine system (LNG-IUS), and its influences on serum sex hormones and recurrence. Methods A retrospective analysis was performed on the clinical data of 280 patients with endometrial polyps (EP) who underwent TCRP from March 2022 to September 2023. According to presence or absence of LNG-IUS, patients were divided into LNG-IUS group (n=141) and control group (n=139). All were followed up for 12 months after surgery. The endometrial thickness, menstrual volume pictorial blood loss assessment chart (PBAC), uterine hemodynamics pulsatility index (PI), and resistance index (RI), levels of serum vascular endothelial growth factor (VEGF), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were compared between the two groups, and recurrence rate was observed by follow-up. Results At 3, 6 and 12 months after surgery, endometrial thickness in LNG-IUS group was lower than that in control group (P<0.05), PBAC scores were lower than those in control group (P<0.05), and levels of serum VEGF, LH and FSH were lower than those in control group (P<0.05). At 12 months after surgery, PI and RI in LNG-IUS group were lower than those in control group (P<0.05). At 12 months after surgery, there were 2 recurrence cases (1.42%) in LNG-IUS group and 11 recurrence cases (7.91%) in control group, respectively. The recurrence rate in LNG-IUS group was lower than that in control group (χ2=6.670, P<0.05). Conclusions Hysteroscopic surgery combined with postoperative progesterone therapy is beneficial to reduce endometrial thickness, menstrual blood loss and risk of postoperative recurrence in patients with endometrial polyps, which has high safety.
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  Analysis of the effects of transvaginal cervical cerclage on pregnancy outcome and fertility desire at different gestational weeks during different timing of the procedure

  YAN Yaqi, DU Xin, ZHOU Xuan, JIN Jing.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 530-533. https://doi.org/10.13390/j.issn.1672-1861.2025.06.013

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  Objective To investigate the effects of transvaginal cervical cerclage (CC) on pregnancy outcomes and on women's fertility desire at different gestational weeks during different timing of the procedure. Methods Retrospective analysis of the pregnancy outcomes of 211 cases of cervical incompetence (CIC) in Hubei maternal and Child Health Hospital from January 2020 to August 2023. They were divided into non-emergency group and emergency group. Each group was further divided into pregnancies<24-week group and≥24-week group. Pregnancy outcomes, fertility desire and the influencing factors of surgical success were analyzed. Results For non-emergency group, there were no statistically significant difference in abortion rate, preterm birth rate, full-term birth rate, gestational weeks of delivery and surgical success rate between pregnancies<24-week group and≥24-week group (P>0.05), and fetal survival rate in pregnancies≥24-week group was higher than<24-week (P<0.05). For emergency group, there were no statistically significant difference in abortion rate, gestational weeks of delivery and surgical success rate between pregnancies<24-week group and≥24-week group (P>0.05). Compared with pregnancies<24-week group, the fetal survival rate and the preterm birth rate in pregnancies≥24-week group was higher (P<0.05), the full-term birth rate was lower (P<0.05). A Shorte of cervical length was a risk factor for surgical failure (OR=2.479, 95%CI: 1.522~4.038, P=0.000). Among the follow-up women (191 individuals), 26 women had fertility desire (13.6%), while 90 women had no fertility desire due to concerns about surgical complications (47.1%), 6 women were not sure to have fertility desire (13.6%), 69 women had no fertility desire due to other reasons (36.1%), the differences between the four groups were statistically significant (P<0.05). Conclusions CC should be performed after 24 weeks to improve pregnancy outcomes. Monitoring of cervical length during pregnancy should be strengthened, especially in women with a history of mid-term miscarriage or premature birth. CC might affect women's fertility desire.
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  Analysis of perinatal outcomes of pregnant women with negative oral glucose tolerance test but fasting serum glucose≥5.1 mmol/L

  WANG Yan, ZHANG Na, WEI Jun, LIU Guoli.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 534-537. https://doi.org/10.13390/j.issn.1672-1861.2025.06.014

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  Objective To analyze the perinatal outcomes of pregnant women with negative 75g oral glucose tolerance test (OGTT) but fasting serum glucose≥5.1 mmol/L. Methods A total of 2 645 pregnant women who received OGTT (plasma glucose) and hepatic function examination (including serum glucose) during 24~28 gestational age were divided into: gestational diabetes mellitus (GDM) group, 52 cases with both fasting plasma and serum glucose≥5.1 mmol/L; GDM uncertain group, 35 cases with negative OGTT but fasting serum glucose ≥5.1 mmol/L; non-GDM group, 2558 cases with negative OGTT and fasting serum glucose<5.1 mmol/L. One-way ANOVA, Chi-square or Fisher's exact test, and Logistic regression analysis were used to calculate the adjusted risk ratio of cesarean delivery, macrosomia, shoulder dystocia, neonatal hypoglycemia, respiratory distress syndrome, admission to pediatric department of GDM uncertain group. Results The birthweight ratio (birthweight/mean birthweight by gestational age and sex) of GDM uncertain group (1.08±0.10) was the highest within the three groups (GDM group 1.05±0.14, non-GDM group 1.02±0.12) (P<0.05). With the non-GDM group as reference, the risk ratio of shoulder dystocia of GDM uncertain group adjusted for age, body mass index, medical risk factors, gestational age at birth was 10.70 (95%CI: 4.53~20.61). Conclusions Although with negative OGTT, pregnant women with fasting serum glucose≥5.1 mmol/L will have higher neonatal birthweight at a same gestational age and risk of shoulder dystocia.
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  Investigation of postpartum vaginal microecology at 42 days and analysis of influencing factors

  WANG Yufeng, WANG Ying, ZHANG Lei, LIAO Qinping.

  Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(6): 538-541. https://doi.org/10.13390/j.issn.1672-1861.2025.06.015

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  Objective To investigate the vaginal microecology of women at 42 days pospartum and influencing factors. Methods Clinical data of 149 women who visited the hospital from March 2020 to June 2020 for reexamination at 42 days postpartum as research group and 100 women who came to hospital for physical examination at the same time as the control group were retrospectively collected. Chi-square test and Fisher’s exact test were used to statistically analyze vaginal microecology results at 42 days postpartum, and logistic regression was applied to analyze influencing factors. Results The research group showed that 13.42% of the results were normal, while in the control group, 72.00% of the results were normal. The difference was statistically significant (P<0.05). Logistic regression analysis demonstrated that factors including premature rupture of membranes, delivery mode, abnormal thyroid function, postpartum hemorrhage, lochia condition, feeding pattern, antibiotic use and gestational diabetes could not affect the occurrence of vaginitis at 42 days postpartum (P>0.05), while postpartum potassium permanganate sitz baths could affect postpartum vaginal microbiota (P<0.05) and showed a protective effect against postpartum vaginitis. Conclusions Majority of maternal vaginal microbiota have not yet recovered to the normal state with predominant lactobacillus at 42 days postpartum, and potassium permanganate sitz bath can effectively prevent postpartum vaginitis.