Analysis of risk factors for bladder neck funnel formation in spontaneous delivery primipara by pelvic floor three-dimensional ultrasound
10.3969/j.issn.1673-9701.2024.27.006
- VernacularTitle:盆底三维超声对顺产初产妇膀胱颈漏斗形成的危险因素分析
- Author:
Liqun WU
1
;
Huiyan ZHAO
;
Meixia WANG
;
Jie GAO
;
Rui YAO
;
Qun XU
Author Information
1. 温州市中西医结合医院妇产科,浙江温州 325000
- Keywords:
Bladder neck funnel;
Stress urinary incontinence;
Three-dimensional ultrasound of pelvic floor;
Pelvic hiatus
- From:
China Modern Doctor
2024;62(27):26-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate value and risk factors of pelvic floor three-dimensional ultrasound parameters in single spontaneous delivery primipara with bladder neck funnel formation at 6-8weeks after delivery.Methods A total of 108 cases of single spontaneous delivery primipara were selected as research objects according to three-dimensional ultrasound indexes of pelvic floor,they were assigned into two groups:Observation group(40 cases)with bladder neck funnel formation and control group(68 cases)without bladder neck funnel formation.Three-dimensional ultrasound indexes of pelvic floor and clinical symptoms were compared between two groups.Results The incidence of stress urinary incontinence(SUI),anterior vaginal wall prolapse,bladder neck distance(BND),posterior urethrovesical angle(PUA)in Valsalva state,levator hiatus area(LHA)in resting and Valsalva states,levator hiatus length(LHL),and changes in LHL(△ LHL)in observation group were all higher than those in control group(P＜0.05).Logistic regression analysis revealed that SUI and anterior vaginal wall prolapse are independent risk factors for bladder neck funnel formation,adjusted OR were 11.255 and 3.643;Resting state and Valsalva state LHA,LHL,and △ LHL were also independent risk factors for bladder neck funnel formation(P＜0.05).Receiver operating characteristic(ROC)curve analysis revealed that area under the curve(AUC)for diagnosing bladder neck funnel formation in SUI and anterior vaginal wall prolapse were 0.744 and 0.615,respectively;In ultrasound indicators,when the LHL of Valsalva state is＞63.5mm,the AUC is 0.706;The diagnostic sensitivity of the combination factor 1(resting state LHA+Valsalva state LHA)is 95.0％;The diagnostic specificity of the combination factor 2(Valsalva state LHL+△LHL)is 80.9％.Conclusion In patients of single spontaneous delivery primipara with bladder neck funnel formation,occurrence of SUI and vaginal anterior wall prolapse,increased LHA and LHL under two states and △LHL were independent risk factors.The diagnostic sensitivity of the combination factor 1 was higher than single index,the diagnostic specificity of the combination factor 2 was higher.
