Introduction
Female pelvic floor dysfunction (PFD) is a complex syndrome involving the impairment of the pelvic floor muscles and tissues. At present, PFD becomes one of the top five most common chronic diseases that seriously affect women’s quality of life. The latest reports show that the prevalence of PFD ranged from 23.7% to 46.5%[1-3]. Pregnancy and childbirth have been recognized as the greatest risk factors of PFD. Due to the physiological changes of pregnancy and childbirth, the increased abdominal pressure and decreased collagen together can weaken pelvic floor muscle(PFM) and loosen pelvic floor tissues. Furthermore, excessive stretching during delivery causes the impairments of PFM, connective tissue and nerves. The pregnant and postpartum women more likely experience PFD, up to approximal 49% [4].
PFD seriously affects women’s physical and mental health. Therefore, early diagnosis and timely treatment is extremely important. The early stages of PFD are the alteration in biochemistry and electrophysiology of the pelvic floor, which may further progress to a symptomatic PFD under the further damage. The pelvic floor sEMG could be used for early diagnosis of PFD, which is an objective and non-invasive method by recording the change of voltage over the PFM fiber membrane. A number of reports confirmed sEMG is reliable in among different populations for measurement of the PFM[5,6]. sEMG assessment based on Glazer protocol are widely used for the evaluation of PFD in postpartum women[7,8]. The Glazer Protocol comprises a series of muscle relaxations and contractions, including rest pre-baseline, phasic contractions, tonic contractions, endurance contraction and rest post-baseline. Glazer Protocol can differentiate the number and type of dysfunction of PFM, and thus, it can support the selection of a proper therapeutic method.
As well known, the delivery mode was a crucial risk factor of PFD[9]. It is necessary to predict and/or diagnosis on early stage of PFD in postpartum women, hence they could be offered timely interventions to prohibit the progression. Most of previous studies applied the qualitative assessment of the different delivery modes on PFD. However, a few studies have reported with quantitative measurements. This study aimed to quantitate the impact of different delivery modes on PFM function at 6-8 weeks postpartum by sECG based on the Glacer protocol. We also tried to distinguish the detail types and grade of PFM impairment, in order to provide the individual therapeutic strategy to patients at the early stage of postpartum.