Effect of different delivery modes on pelvic floor structure revealed by ultrasonography

Objective: This study is to investigate the effect of different delivery modes on pelvic floor structure by using ultrasonography. Method: A total of 194 cases of patients visited Liaocheng Peoples’ Hospital aged between 25 to 40 y old were enrolled in this retrospective study. According to their fertility status, these 194 cases were divided into childless group and fertility group. The fertility group was divided into vaginal delivery group and cesarean section group according to the delivery modes. GE E8 cavity was used to detect relative distances (bladder neck-symphyseal short, BSD; bladder neck descent, BND; detrusor thickness, DT) and angles (bladder urethra after angle, bladder neck rotation angle) of each group in different states. We compare the differences between groups by corresponding statistical methods. Results: There was no significant difference in BSD, DT and posterior vesicourethral angle (β) between childless and fertility groups under the resting states, while β was different between vaginal delivery and cesarean delivery groups. During Valsalva movement, BND, β, and bladder neck rotation angle were different between each groups, and the differences were statistically significant. The stress urinary incontinence diagnosis rate of fertility group was statistically higher than that of childless group, and so did the vaginal delivery and cesarean delivery. Conclusion: Pregnancy and delivery can damage the pelvic floor system, and the pelvic anatomy changes caused by delivery might play a key role in the postpartum stress urinary incontinence. These results can provide the useful information to establish the meaningful guidelines to assist both patients and health care providers in making decision.