[The effect of episiotomy on pelvic floor muscle function within six months after first childbirth through electromyography and questionnaires assessment].

Objective: To compare the impact of mediolateral episiotomy on pelvic floor muscle (PFM) function through surface electromyography (sEMG) and quality of life questionnaire assessment. Methods: From January 2018 to June 2019, 1 250 eligible primiparous women were enrolled in Beijing Hospital and the First People's Hospital of Yunnan Province. Participants were divided into episiotomy group (n=676)and non-episiotomy group (n=574). Both groups underwent clinical pelvic examination, sEMG assessment, and quality of life (QOL) questionnaire assessment at two fixed time points: 6-8 weeks, 6 months after vaginal delivery. Follow-up of sEMG amplitudes and their correlation with QOL questionnaire scores were evaluated. Results: Among the women delivered with episiotomy, the peak amplitude of phasic contraction (PPC) was (17.7±5.3) µV at 6-8 weeks after childbirth and (29.6±8.7) µV at 6 months after childbirth. The mean amplitude of tonic contraction (MTC) was (14.8±7.4) µV and (22.2±8.9) µV, respectively. In the non-episiotomy group, PPC was (20.0±7.9) µV and (35.4±10.7) µV at 6-8 weeks and 6 months, and MTC was (17.8±9.0) µV and (27.5±8.9) µV, respectively. Compared with EMG amplitudes at 6-8 weeks, both PPC and MTC significantly improved at 6 months in both groups (all P<0.01). Moreover, episiotomy was related with significantly lower PPC and MTC at both fixed checkups. Besides, both IIQ-7 and PFIQ-7 questionnaire scores improved at 6 months compared with those at 6-8 weeks in both groups (all P<0.001). There was consistently significant difference in QOL scores between episiotomy and non-episiotomy group at two checkups (all P<0.05). A negative correlation was observed between PFM contractile amplitudes and QOL scores at both time points after childbirth (all P<0.05), and the correlation weakened with time. Conclusion: Episiotomy has a negative impact on the postpartum PFM contractile function within 6 months after childbirth. The negative correlation between the sEMG and QOL scores indicates that sEMG is a candidate assessment for PFM function follow-up after childbirth.

[Multiple factors analysis of early postpartum pelvic floor muscles injury in regenerated parturients].

Objective: To investigate the risk factors for multiparous pelvic floor muscles injury during 6-8 weeks after delivery. Method: From June 2015 to April 2017, 1917 women (1 523 primigravidas and 294 multiparas) were accepted postpartum pelvic floor function screening during 6-8 weeks after delivery in Beijing Hospital.Pelvic examination and pelvic floor muscle strength testing were carried out in these women.All the data were analyzed with multivariate logistic regression method to explore the related factors for postpartum pelvic floor muscle injury. Result: The incidence of muscle strength grades less than third grade was 63.60 % (type Ⅰ muscle fiber) and 24.83 % (type Ⅱ muscle fiber). Multivariate analysis showed that time interval, between two deliveries, less than 3 years (OR=2.16, 95%CI 1.21-3.86), and maternal BMI<18.5 (OR=3.04, 95%CI 1.10-9.30) and BMI≥28 (OR=3.04, 95%CI 1.10-9.30) before pregnancy were risk factors for postpartum injury of type Ⅰ muscle fiber. Gestational age more than 40 weeks increased the risk of damaging type Ⅱ muscle fiber (OR=2.79, 95%CI 1.156-6.76). Compared with cesarean section, vaginal delivery significantly increased the risk of injury of type Ⅰ and Ⅱ pelvic floor muscle fibers (P<0.05). Conclusion: The incidence of multiparous pelvic floor muscle injury was high in early postpartum period.Several factors are related to the pelvic floor muscle injury.Pelvic floor rehabilitation in early postpartum and maternal education may be helpful to reduce the radio of injury.