Predict risk factors of pelvic floor three-dimensional ultrasound indicators in primiparae ofnaturalchildbirth women with bladder neck funnel formation

Corresponding author: WANG Meixia, 67614162@qq.com

DOI: 10.12201/bmr.202407.00020

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  Abstract: Objective To investigate value and risk factors of pelvic floor three-dimensional ultrasound parameters in natural childbirth primiparae with bladder neck funnel formation at 6-8weeks after delivery. Methods A total of 108 cases of primiparae were selected as research objects. Then 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. Meaningful indicators were analyzed. Results ①The findings showed that the rate of SUI and vaginal anterior wall prolapse 、bladder neck distance (BND)、posterior urethrovesical angle（PUA)in valsalva state、levator hiatus area（LHA）at resting state、LHA under valsalva state、levator hiatus length (LHL) under two states and LHL variation（△LHL）in the observation group were higher than those in the control group，and the differences were statistically significant（P＜0.05）.②Logistic regression analysis showed that the increased rate of SUI and vaginal anterior wall prolapsed were independent risk factors of bladder neck funnel formation，OR were 11.255 and 3.643.LHA and LHL under two states and△LHL were also independent risk factors of urethral funnel formation（P＜0.05）.③ROC curve analysis showed that AUC of SUI and vaginal anterior wall prolapse were 0.744and0.615.When set the critical value of LHA at resting state as 20.1cm2、LHA at valsalva state as 28.4cm2 and LHL at valsalva state as 63.5mm，the area under the ROC curve for diagnosis of bladder neck funnel formationwere0.640、0.637 and 0.706.The area under the curve(AUC) of combination of two state LHA was 0.636,the diagnostic sensitivity for bladder neck funnel formation was 95.0%.The AUC of combination of LHL under valsalva state and LHL variation（△LHL） was 0.751,the diagnostic specificity was 80.9%.ConclusionIn patients of singleton natural childbirth primipara with bladder neck funnel formation, rate of SUI and vaginal anterior wall prolapse、increasedLHA and LHL under two statesand △LHL were independent risk factors. The diagnostic sensitivity of the combination factor one was higher then single index. The diagnostic specificity of the combination factor two was higher.

  Key words: bladder neck funnel；stress urinary incontinence；three-dimensional ultrasound of pelvic floor；levator hiatus

  Submit time: 11 July 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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