Ultrasound analysis of the effect of second delivery on pelvic floor function in Chinese women

Abstract

In our study, patients who had a second delivery were categorised into the following 4 groups. Pelvic floor ultrasound data were compared during the 6th week after the second delivery. The incidence of cystoceles was highest in group A and lowest in group D. In addition, groups A and B had a higher rate of rectoceles or perineum descent. Similarly, the areas of the levator hiatus were higher in Groups A and B during Valsalva manoeuvres. The area of the levator hiatus from the resting state to the Valsalva manoeuvre effect had the greatest change in Group A. A comparison of the PR thickening rates among the four groups did not reveal significant differences. All second delivery methods can cause varying degrees of pelvic organ prolapse and decreased pelvic floor function; however, vaginal delivery as the second delivery mode may have a more significant effect in Chinese women.

Impact Statement

• What is already known on this subject? Different modes of delivery have significantly different effects on female pelvic floor function. Pregnancy beyond 35 weeks of gestation has an effect on female pelvic floor function, irrespective of the mode of delivery.

• What do the results of this study add? This study analysed the impact of different delivery modes on Chinese female pelvic floor function. Parous women who underwent different modes of second delivery all demonstrated different degrees of pelvic organ prolapse, as well as pelvic floor function decline.

• What are the implications of these findings for clinical practice and/or further research? Our study will provide basic research of Chinese female pelvic floor function after a second delivery, which will be of clinical significance around the world, as well as in China. China will keep promoting further delivery as the aging population is increasing. If the developing countries want to promote the second delivery around the women, they have basic research and data to instruct the females.

Keywords:

• Chinese females
• pelvic floor function
• second delivery
• ultrasonography

Author contributions

Study concepts: Xiao-Hui Shao, De-Jiao Kong; Literature research: Li-Wei Zhang, Lu-Lu Wang; Clinical studies: All authors; Data acquisition: Si-Ming Wang; Data analysis: Li-Juan Yu, Xiao-Qiu Dong; Manuscript preparation: Xiao-Hui Shao; Manuscript editing: De-Jiao Kong; Manuscript review and critical revisions: Li-Wei Zhang, Lu-Lu Wang.

Research involving human participants and/or animals

This study was conducted according to the principles of the Declaration of Helsinki and approved by the Ethics Committee of Harbin Medical University.

Informed consent

Informed consent was obtained from all individual participants included in the study in written form.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was supported by the grant from the Heilongjiang Health and Family Planning Commission Project [No. 2017-142 to Xiao-Hui Shao], National Natural Science Foundation of China [No. 81671771 to Li-Juan Yu] and Hainan Natural Science Fund [No. 2018CXTD347 to Li-Juan Yu], China.