The evaluation value of pelvic floor ultrasound combined with serum TGF-β1 and elastin in early postpartum pelvic floor function of primipara

Objective To investigate the evaluation value of pelvic floor ultrasonography combined with serum TGF-β1 and elastin in early postpartum pelvic floor function of primipara.

Methods A total of 122 primiparas who delivered in the obstetrics and gynecology department and underwent regular postpartum reexaminations in the ultrasound medicine department, were selected. The patients were divided into the PFD group and non-PFD group according to whether pelvic floor dysfunction (PFD) occurred after 42 days of delivery. All patients underwent perineal ultrasound examination. Ultrasound images were collected in the resting state and Valsalva state, respectively. The ultrasound parameters, serum TGF-β1 and elastin expressions between two groups were compared. To analyze the factors influencing the occurrence of postpartum PFD in primiparas, and the receiver operating characteristic (ROC) curve was drew to evaluate the predictive value of ultrasound parameters and serum levels of TGF-β1 and elastin for early postpartum PFD in primiparas.

Results Among the 122 patients, 39 developed PFD, with an incidence rate of 31.97%. The area of the levator ANI muscle hole (LHA) in the rest and Valsalva state and difference value of LHA between rest and Valsalva state (ΔLHA) in the PFD group were higher than those in non-PFD group. The thickness of the puborectalis muscle (PMT), difference value of PMT between rest and Valsalva state (ΔPMT) and expression levels of serum TGF-β1 and elastin in the PFD group were all lower than those in non-PFD group (P ＜ 0.01). The age increasing, prenatal body mass index increasing, second stage of labor prolonging, ΔLHA and ΔPMT were the risk factors affecting early postpartum PFD in primiparas, while the serum levels of TGF-β1 and elastin increasing was a protective factor (P ＜ 0.05). The results of ROC showed that the AUC of the combined detection of early PFD by ΔLHA, ΔPMT, serum TGF-β1 and elastin was 0.914.

Conclusions The ΔLHA, ΔPMT, serum TGF-β1 and elastin are closely related to early postpartum PFD in primiparas. The combined detection efficiency is higher than that of single detection, which can be used as an early predictor of postpartum PFD.