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.