ABSTRACT
Objective To evaluate the impact of different delivery ways on levator ani muscle elasticity in early postpartum women with transperineal three-dimensional ultrasound.Methods Totally 60 postpartum women (30 in spontaneous transvaginal delivery group and 30 in selective cesarean delivery group) and 30 non-fertile women (control group) were enrolled.All subjects underwent transperineal three-dimensional ultrasound.The images were acquired at rest,Valsalva and maximal levator ani muscle contraction,respectively,and then the area (A),circumference (C) of levator hiatus and the length (L) of levator ani muscle were measured.The difference values of A,C,L (△A,△C,△L)were calculated between contraction and rest,and the strain rate (ε) was calculated at contraction.The difference of A,C,L (△A',△C',△L') were calculated between Valsalva and rest,and strain rate (ε') was calculated at Valsalva.Results The △A,△C,△L,ε in spontaneous transviginal delivery group and selective cesarean delivery group were smaller than those in control group (all P＜0.05),and △A',△C',△L',ε'in spontaneous transviginal delivery group and selective cesarean delivery group were larger than those in control group (all P＜0.05),while there was no statistical difference between spontaneous transviginal delivery group and selective cesarean delivery group of △A,△C,△L,ε,△A',△C',△L'nor ε'(all P＞0.05).Conclusion The levator ani muscle elasticity decreases in the early postpartum women,and selective cesarean delivery has limited role in protection of levator ani muscle.