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Characteristics of pelvic diaphragm hiatus in postpartum women with constipation detected dynamically by transperineal three-dimensional ultrasonography |
MU Liang1, LIU Li1, NAN Shuliang1, WEI Aihua1, HAO Rui1, GUAN Xiangping1, LI Bin2, and HU Ying2. |
1.Ultrasound Diagnosis Center, 2.Department of Gynecology & Obstetrics, Shaanxi Provincial People’s Hospital, Xi’an 710068,China |
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Abstract Objective To observe dynamically the morphological characteristics of the pelvic diaphragm hiatus in postpartum women with constipation by transperineal three-dimensional ultrasonography.Methods One hundred and twenty postpartum women who underwent transperineal 3-D ultrasound examination at the Department of Obstetrics and Gynecology between January 2014 and December 2016,including 48 postpartum women with constipation and another 72 postpartum women without constipation, were selected as the subjects.In the meantime,100 normal nulliparous healthy women without constipation were chosen as the control group.The morphological characteristics, perimeter and area of the pelvic diaphragm hiatus as well as pubovisceral muscle thickness were measured at rest, on maximum pelvic floor contraction and maximum Valsalva by 3-D ultrasound, respectively.Results Loose connective tissue was observed in postpartum women.The perimeter and area of the pelvic diaphragm hiatus and pubovisceral muscle thickness were increased more significantly in postpartum women than in the control group at rest, on maximum pelvic floor contraction and maximum Valsalva respectively (P<0.05).The perimeter and area of the pelvic diaphragm hiatus in postpartum women with constipation were increased more considerably than in those without constipation during the three maneuvers,respectively(P<0.05).Pubovisceral muscle thickness in postpartum women with constipation was significantly thinner than that of those without constipation at maximum pelvic floor contraction(t=2.41, P<0.05), but there was no significant difference between postpartum women with constipation and those without constipation at rest and on maximum Valsalva in pubovisceral muscle thickness (P>0.05).Conclusions Pelvic floor anatomic remodeling is identified in postpartum women.Transperineal three-dimensional ultrasonography is of great value for observing pelvic floor changes in postpartum women, especially in postpartum women with constipation.
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Received: 20 January 2018
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