Chinese Medical E-ournals Database
Adv Search
中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2022, Vol. 18 ›› Issue (03): 366 -372. doi: 10.3877/cma.j.issn.1673-5250.2022.03.017

Review

Research status of pelvic floor dysfunction diseases during pregnancy and postpartum and its prevention and treatment

Xuan Zheng1, Yun Zhao2,†()   

  1. 1School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
    2Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong Universtiy of Science and Technology, Wuhan 430070, Hubei Province, China
  • Received:2022-03-15 Revised:2022-05-10 Published:2022-06-01
  • Corresponding author: Yun Zhao
  • Supported by:
    Key Project of Hubei Provincial Natural Science Foundation(2019CFA033); Innovation Team Project of Health Commission of Hubei Province(WJ2018H0133)
HTML ( ) PDF ( )

Pregnancy and postpartum pelvic floor dysfunction diseases (PFDD) have attracted much attention in recent years, mainly including pelvic organ prolapse (POP), stress urinary incontinence (SUI), fecal incontinence (FI), sexual dysfunction (SD), chronic pelvic pain, etc.. Pregnancy and childbirth are one of the independent risk factors for PFDD. With implementation of national " three-child" policy, gravidity and parity of women of childbearing age has increased, and various problems, mainly postpartum pelvic floor dysfunction have become increasingly prominent, and the demand for medical treatment has increased. PFDD seriously affect women′s quality of life. The author intends to expound on the latest research progress of impact of pregnancy and childbirth on female pelvic floor function, the above 5 different types of PFDD during pregnancy and postpartum, and its prevention and non-surgical and surgical treatment measures.

Key words: Cesarean section, Vaginal delivery, Pelvic floor disorders, Pelvic floor dysfunction disease, Pelvic floor muscle training, Transcutaneous electric nerve stimulation, Biofeedback, Surgical procedures, operative, Female
[1]
Baud D, Sichitiu J, Lombardi V, et al. Comparison of pelvic floor dysfunction 6 years after uncomplicated vaginal versus elective cesarean deliveries: a cross-sectional study[J]. Sci Rep, 2020, 10(1): 21509. DOI: 10.1038/s41598-020-78625-3.
[2]
Grant A, Currie S. Qualitative exploration of the acceptability of a postnatal pelvic floor muscle training intervention to prevent urinary incontinence[J]. BMC Womens Health, 2020, 20(1): 9. DOI: 10.1186/s12905-019-0878-z.
[3]
Verbeek M, Hayward L. Pelvic floor dysfunction and its effect on quality of sexual life[J]. Sex Med Rev, 2019, 7(4): 559-564. DOI: 10.1016/j.sxmr.2019.05.007.
[4]
Flynn A, Macaluso M, D′Empaire I, et al. Wernicke′s encephalopathy: increasing clinician awareness of this serious, enigmatic, yet treatable disease[J]. Prim Care Companion CNS Disord, 2015, 17(3): 10.4088/PCC.14r01738. DOI: 10.4088/PCC.14r01738.
[5]
Guerby P, Parant O, Chantalat E, et al. Operative vaginal delivery in case of persistent occiput posterior position after manual rotation failure: a 6-month follow-up on pelvic floor function[J]. Arch Gynecol Obstet, 2018, 298(1): 111-120. DOI: 10.1007/s00404-018-4794-5.
[6]
彭晓梅，刘颖. 阴道助产对产后盆底功能的影响[J]. 中国性科学，2018, 27(11): 96-99. DOI: 10.3969/j.issn.1672-1993.2018.11.029.
[7]
杨明丽，王青，于晓杰，等. 5 143例产后早期妇女的盆底功能状况及其影响因素分析[J]. 中华妇产科杂志，2019, 54(8): 522-526. DOI: 10.3760/cma.j.issn.0529-567x.2019.08.004.
[8]
Zhou B, Zhang H, Yuan J, et al. Pelvic floor assessment using magnetic resonance imaging after vaginal delivery and elective caesarean delivery[J]. Int Urogynecol J, 2021, 32(11): 3023-3029. DOI: 10.1007/s00192-020-04514-y.
[9]
Myer ENB, Roem JL, Lovejoy DA, et al. Longitudinal changes in pelvic floor muscle strength among parous women[J]. Am J Obstet Gynecol, 2018, 219(5): 482.e1-482.e7. DOI: 10.1016/j.ajog.2018.06.003.
[10]
Zhao Y, Zou L, Xiao M, et al. Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara[J]. BMC Pregnancy Childbirth, 2018, 18(1): 275. DOI: 10.1186/s12884-018-1918-7.
[11]
王华，郭广林. 巨大胎儿对产妇盆底功能的影响[J/OL]. 中华妇幼临床医学杂志(电子版), 2018, 14(2): 230-235. DOI: 10.3877/cma.j.issn.1673-5250.2018.02.017.
[12]
中华医学会妇产科学分会妇科盆底学组. 盆腔器官脱垂的中国诊治指南(2020年版)[J]. 中华妇产科杂志，2020, 55(5): 300-306. DOI: 10.3760/cma.j.cn112141-20200106-00016.
[13]
Geynisman-Tan JM, Taubel D, Asfaw TS. Is something missing from antenatal education? A survey of pregnant women′s knowledge of pelvic floor disorders[J]. Female Pelvic Med Reconstr Surg, 2018, 24(6): 440-443. DOI: 10.1097/SPV.0000000000000465.
[14]
王青，于晓杰，杨欣，等. 产程中不同时间行剖宫产术妇女产后盆腔器官脱垂状况的分析[J]. 中华妇产科杂志，2019, 54(11): 751-755. DOI: 10.3760/cma.j.issn.0529-567x.2019.11.007.
[15]
Dolan LM, Hilton P. Obstetric risk factors and pelvic floor dysfunction 20 years after first delivery[J]. Int Urogynecol J, 2010, 21(5): 535-544. DOI: 10.1007/s00192-009-1074-8.
[16]
Reimers C, Siafarikas F, Stær-Jensen J, et al. Risk factors for anatomic pelvic organ prolapse at 6 weeks postpartum: a prospective observational study[J]. Int Urogynecol J, 2019, 30(3): 477-482. DOI: 10.1007/s00192-018-3650-2.
[17]
袁峥，尹格平，李娟，等. 新式阴道前壁补片修补术治疗压力性尿失禁女性患者的疗效分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2017, 13(2): 194-198. DOI: 10.3877/cma.j.issn.1673-5250.2017.02.013.
[18]
Rogers RG, Ninivaggio C, Gallagher K, et al. Pelvic floor symptoms and quality of life changes during first pregnancy: a prospective cohort study[J]. Int Urogynecol J, 2017, 28(11): 1701-1707. DOI: 10.1007/s00192-017-3330-7.
[19]
Chan SS, Cheung RY, Yiu KW, et al. Prevalence of urinary and fecal incontinence in Chinese women during and after their first pregnancy[J]. Int Urogynecol J, 2013, 24(9): 1473-1479. DOI: 10.1007/s00192-012-2004-8.
[20]
Mørkved S, Bø K. Prevalence of urinary incontinence during pregnancy and postpartum[J]. Int Urogynecol J Pelvic Floor Dysfunct, 1999, 10(6): 394-398. DOI: 10.1007/s001920050067.
[21]
Brown S, Gartland D, Perlen S, et al. Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study[J]. BJOG, 2015, 122(7): 954-962. DOI: 10.1111/1471-0528.12963.
[22]
钟若忻，王妍，葛霖. 产后大便失禁的发病及评估、干预措施[J]. 中华医学杂志，2018, 98(11): 872-874. DOI: 10.3760/cma.j.issn.0376-2491.2018.11.017.
[23]
刘俊，唐瑶，黄娟，等. 盆腔脏器脱垂定量分度法对不同方式分娩初产妇产后近期盆底功能的评价[J/OL]. 中华妇幼临床医学杂志(电子版), 2018, 14(1): 25-30. DOI: 10.3877/cma.j.issn.1673-5250.2018.01.004.
[24]
Hickman LC, Propst K. Accurate diagnosis and repair of obstetric anal sphincter injuries: why and how[J]. Am J Obstet Gynecol, 2020, 222(6): 580.e1-580.e5. DOI: 10.1016/j.ajog.2020.02.044.
[25]
Gutzeit O, Levy G, Lowenstein L. Postpartum female sexual function: risk factors for postpartum sexual dysfunction[J]. Sex Med, 2020, 8(1): 8-13. DOI: 10.1016/j.esxm.2019.10.005.
[26]
Jones C, Cameron M. Pelvic girdle pain during pregnancy and puerperium[J]. J Obstet Gynaecol, 2012, 32(6): 607-608. DOI: 10.3109/01443615.2012.685904.
[27]
Santos MD, Palmezoni VP, Torelli L, et al. Evaluation of pelvic floor muscle strength and its correlation with sexual function in primigravid and non-pregnant women: a cross-sectional study[J]. Neurourol Urodyn, 2018, 37(2): 807-814. DOI: 10.1002/nau.23353.
[28]
Quoc Huy NV, Phuc An LS, Phuong LS, et al. Pelvic floor and sexual dysfunction after vaginal birth with episiotomy in vietnamese women[J]. Sex Med, 2019, 7(4): 514-521. DOI: 10.1016/j.esxm.2019.09.002.
[29]
张仙. 孕期凯格尔训练对初产妇围产期尿失禁及产程的影响[J]. 实用临床医学，2018, 19(9): 62-63, 99. DOI: 10.13764/j.cnki.lcsy.2018.09.022.
[30]
Dumoulin C, Cacciari LP, Hay-Smith E. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women[J]. Cochrane Database Syst Rev, 2018, 10(10): CD005654. DOI: 10.1002/14651858.CD005654.pub4.
[31]
Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction[J]. World J Urol, 2012, 30(4): 437443. DOI: 10.1007/s0034501107798.
[32]
夏杰，段霞，于婵，等. 盆底肌训练改善产后压力性尿失禁的Meta分析[J]. 重庆医学，2020, 49(22): 3817-3822. DOI: 10.3969/j.issn.1671-8348.2020.22.030.
[33]
李颖，徐换，郝赤子. 等. 盆底肌训练治疗女性盆腔器官脱垂疗效的Meta分析[J]. 中国康复医学杂志，2018, 33(11): 1328-1332. DOI: 10.3969/j.issn.1001-1242.2018.11.015.
[34]
Zhou Z, Liu CH, Deng CY. Clinical observation of biofeedback electrical stimulation combined with pelvic floor muscle exercise in the treatment of postpartum pelvic floor dysfunction[J]. Chin J Fam Plan Gynecotokol, 2019, 11(5): 64-67. DOI: 10.3969/j.issn.1674-4020.2019.04.15.
[35]
Mazur-Bialy AI, Kołomańska-Bogucka D, Opławski M, et al. Physiotherapy for prevention and treatment of fecal incontinence in women-systematic review of methods[J]. J Clin Med, 2020, 9(10): 3255. DOI: 10.3390/jcm9103255.
[36]
赵金荣，王海波，李萍，等. 产后早期盆底肌功能训练对会阴及盆底肌康复效果观察[J]．临床合理用药杂志，2014，7(17):104-105.DOI：10.15887/j.cnki.13-1389/r.2014.17.026.
[37]
张宁宁. 盆底电刺激生物反馈疗法治疗盆底功能障碍[J]. 继续医学教育，2020, 34(2): 85-86. DOI: 10.3969/j.issn.1004-6763.2020.02.046.
[38]
Richmond CF, Martin DK, Yip SO, et al. Effect of supervised pelvic floor biofeedback and electrical stimulation in women with mixed and stress urinary incontinence[J]. Female Pelvic Med Reconstr Surg, 2016, 22(5): 324-327. DOI: 10.1097/SPV.0000000000000279.
[39]
余琳，程艳，张娟，等. 平滑肌电刺激技术治疗产后42天后会阴疼痛的探索性研究[J]. 临床和实验医学杂志，2020, 19(5): 546-549. DOI: 10.3969/j.issn.1671-4695.2020.05.030.
[40]
Aydin S, ArIoǧlu AydIn Ç, Batmaz G, et al. Effect of vaginal electrical stimulation on female sexual functions: a randomized study[J]. J Sex Med, 2015, 12(2): 463-469. DOI: 10.1111/jsm.12788.
[41]
刘耀丹，洪莉. 盆底电刺激技术的机制研究及临床应用进展[J]. 中国计划生育和妇产科，2017, 9(7): 21-27. DOI: 10.3969/j.issn.1674-4020.2017.07.07.
[42]
Ladi-Seyedian SS, Sharifi-Rad L, Nabavizadeh B, Kajbafzadeh AM. Traditional biofeedback vs. pelvic floor physical therapy-is one clearly superior？[J]. Curr Urol Rep, 2019, 20(7): 38. DOI: 10.1007/s11934-019-0901-9.
[43]
Nunes EFC, Sampaio LMM, Biasotto-Gonzalez DA, et al. Biofeedback for pelvic floor muscle training in women with stress urinary incontinence: a systematic review with Meta-analysis[J]. Physiotherapy, 2019, 105(1): 10-23. DOI: 10.1016/j.physio.2018.07.012.
[44]
Lacima G, Pera M, González-Argenté X, et al. Is electromyography a predictive test of patient response to biofeedback in the treatment of fecal incontinence？[J]. Neurourol Urodyn, 2016, 35(3): 390-394. DOI: 10.1002/nau.22715.
[45]
Bugge C, Adams EJ, Gopinath D, et al. Pessaries (mechanical devices) for managing pelvic organ prolapse in women[J]. Cochrane Database Syst Rev, 2020, 11(11): CD004010. DOI: 10.1002/14651858.CD004010.pub4.
[46]
Dwyer L, Kearney R, Lavender T. A review of pessary for prolapse practitioner training[J]. Br J Nurs, 2019, 28(9): S18-S24. DOI: 10.12968/bjon.2019.28.9.S18.
[47]
张弛，刘柏隆，周祥福. 女性压力性尿失禁的诊疗进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(6): 537-541. DOI: 10.3877/cma.j.issn.1674-3253.2021.06.020.
[48]
Malouf AJ, Norton CS, Engel AF, et al. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma[J]. Lancet, 2000, 355(9200): 260-265. DOI: 10.1016/S0140-6736(99)05218-6.
[49]
孙桂东，邵万金. 成人大便失禁的诊断和治疗[J]. 临床外科杂志，2018, 26(4): 313-316. DOI: 10.3969/j.issn.1005-6483.2018.04.022.
[1] Shuqin Zhang, Lian Chen. Diagnosis and treatment of postpartum intrauterine retained products of conception[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 493-497.
[2] Jiechun Shi, Ziyu Fan, Yan Xing. Early warning efficiency of different screening methods on cervical adenocarcinoma in situ[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 575-581.
[3] Dan Tang, Xiaoxi Yao, Bowen Yang, Shaolong Xue, Mengyao Li, Liuxing Wei, Mingrong Xi. The impact of doublecortin-like kinase 1 on the clinical characteristics of endometrioid adenocarcinoma patients[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 582-590.
[4] Yi Wei, Yuxi Zhou, Ye Yang, Xiufeng Ling, Chun Zhao. Current research status on roles of microRNA on endometrial receptivity[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 266-270.
[5] Lin Lin, Simeng Tian, Yonghua Yu, Feifei Xu, Mingli Huang. Current research status on treatment of intrauterine adhesion by stem cells and their exosomes[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 271-275.
[6] Xin Li, Yi Wei, Juan Zhang, Juanjuan Zhang, Xiufeng Ling, Chun Zhao, Mianqiu Zhang. Influencing factors on clinical pregnancy outcomes of frozen-thaw embryo transfer cycle in women of advanced age[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 276-283.
[7] Hui Hua, Chenying Xu, Jinfeng Liu. Effect of pelvic floor muscle training timing on postpartum pelvic floor muscle tension and sexual function of elderly primiparae[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 284-291.
[8] Jiaxuan Wang, Liqu Huang, Yunfei Guo. Clinical application of bladder neck suspension in treatment of children with neurogenic urinary incontinence[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 179-184.
[9] Weicong Gao, Li Li, Zhonghua Zhang, Xianghui Zhu, Suqiao Liu. Impact of impaired glucose regulation on recurrence within 2 years after modified radical surgery in patients with cervical cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 231-237.
[10] Yuping Li, Hui Ma, Hang Yu. Clinical efficacy of laparoscopic uterine artery ligation combined with myomectomy for the treatment of uterine fibroids[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 238-244.
[11] Lin Yang, Rutie Yin. Current research status on etiology and treatment of patients with white lesions of vulva[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 157-165.
[12] Li Wang, Yueying Wang, Fen Zhou, Yukun Guo, Lina Wei. Current research status in effect of gonadotropin-releasing hormone antagonist on endometrial receptivity[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 629-635.
[13] Likun Wei, Xuhong Zhang, Ying Luo, Fengxia Xue, Yingmei Wang, Xueru Song, Lina Tian, Yanfang Zhang, Yanxia Wang, Wenyan Tian. Malignant transformation of ovarian endometrioma and pelvic abscesses: a case report and literature review[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 696-702.
[14] Guanghua Liu, Qiang Ouyang, Juming Yu, Guoping Fan, Jingmin Ou, Mingke Qiu, Feikai Lin, Huizhen Sun, Hui Zhang, Xipeng Wang, Minfei Jin. Clinical application of caesarean section assisted by bilateral internal iliac artery balloon occlusion with sequential uterine artery embolization[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(01): 33-38.
[15] Liping Wang, Yuqin Nie, Aili Zhu. Application value of pelvic floor myoelectric stimulation combined with biofeedback therapy in female patients with post-stroke urinary incontinence[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(02): 129-133.
Viewed
Full text


Abstract

Copyright © Chinese Medical Association, Chinese Medical Multimedia Press  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号