Clinical and Ultrasonographic Evaluation of the Pelvic Floor in Primiparous Women after Normal Vaginal Delivery with Episiotomy and without Episiotomy

Nora H. K. Elabady, A. Awara, Amr El-badry, Nareman M. El-Hamamy
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Abstract

Objective The aim of this prospective study is clinical and ultrasonographic evaluation of the pelvic floor in primiparous women after normal vaginal delivery with episiotomy and without episiotomy. Methods This is a cross-section study of primiparous women with a history of delivery at Tanta University Hospital from August 2018 to August 2019. The sample power was calculated based on avulsion (major and minor) in two groups (vaginal delivery with episiotomy and without episiotomy) of total forty-primiparous women with an interval after delivery (20 cases after normal vaginal delivery with episiotomy and 20 cases after normal vaginal delivery without episiotomy). Results Twenty-four hours of delivery there was a highly significant difference between group A (with episiotomy) and group B (without episiotomy) regarding to ultrasound abnormalities, degree of tear, blood loss, hemoglobin concentration and clinical findings, while no difference regarding levator ani weakness. Two months later from delivery there was no significant difference between group A and group B regarding to ultrasound abnormalities and levator ani weakness while there was a difference between the two groups in regarding with clinical findings. Conclusion Normal vaginal delivery without episiotomy in primiparous women is better than normal vaginal delivery with episiotomy as there is no perineal tenderness, no dyspareunia. Low incidence of urinary, rectal incontinence, tear and perineal infection.
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阴道正常分娩的初产妇经外阴切开术和不经外阴切开术后盆底的临床和超声评价
目的本前瞻性研究的目的是阴道正常分娩的初产妇在会阴切开术和不会阴切开术后盆底的临床和超声评价。方法对2018年8月至2019年8月在坦塔大学医院有分娩史的初产妇进行横断面研究。根据40例分娩后间隔时间(正常分娩后伴有会阴切开术20例,正常分娩后不伴有会阴切开术20例)阴道分娩两组(阴道分娩后伴有会阴切开术和阴道分娩后不伴有会阴切开术20例)的撕脱(严重和轻微),计算样本幂。结果a组与B组在分娩24 h时超声异常、撕裂程度、出血量、血红蛋白浓度及临床表现均有极显著性差异,而提肛肌无力无显著性差异。分娩2个月后,A组和B组在超声异常和提肛肌无力方面无显著差异,但在临床表现方面有差异。结论初产妇无会阴压痛、无性交困难,经阴道正常分娩不经会阴切开术优于经阴道正常分娩。尿失禁、直肠失禁、撕裂、会阴感染发生率低。
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