产后妇女盆底器官脱垂情况调查及影响因素分析

目的:调查产后妇女盆底器官脱垂的情况并探讨人口学特征、运动习惯和产科等因素对盆底器官脱垂的影响。方法:纳入2015年10月至2016年4月产后6~8周到上海交通大学附属同仁医院产后门诊做常规体检的产妇852例。采用自填问卷方式收集研究对象人口学特征、产科信息、孕前参加体育锻炼情况等信息,并由妇科医生进行盆底器官脱垂的检查。结果:852例产后6~8周产妇中84.25%有阴道脱垂,55.61%的产妇为Ⅰ度脱垂,28.64%的产妇为Ⅱ度脱垂,未发现Ⅲ度或Ⅳ度阴道脱垂。仅有5例有Ⅰ度子宫脱垂。多分类有序Logistic回归显示,巨大儿(OR 2.469,95%CI 1.029~5.927)、产次≥2次(OR 2.730,95%CI 1.929~3.864)、阴道分娩(OR 43.257,95%CI25.505~73.353)、紧急剖宫产(OR 2.139,95%CI 1.266~3.615)是影响产妇阴道脱垂的高危因素。结论:产后6~8周的产妇轻度阴道脱垂的比例较高。阴道分娩、巨大儿和多产次对阴道脱垂的影响较大。

Investigation of Vaginal Prolapse and Influencing Factors Analysis of Puerpera

Objective:To investigate the prevalence of pelvic organ prolapse and explore the effects of demographic characteristics,exercise habits and obstetric factors on pelvic organ prolapse of puerpera.Methods:To recruit the puerpera taking routine physical examination 6 to 8 weeks postpartum in Tongren Hospital,Shanghai Jiaotong University School of Medicine from October 2015 to April 2016.The data of demographic characteristics,obstetric information and physical exercise status before pregnancy was extracted from self-administered questionnaires.Pelvic organ prolapse was checked by the gynecologist for each participant.Results:Among 852 puerpera 6 to 8 weeks postpartum,84.25％ were found with vaginal prolapse(55.61％ in stagel,28.64％ in stage Ⅱ and none in stage Ⅲ orⅣ).Only 5 women presented uterine prolapse of stage Ⅰ and the remaining stayed none uterine prolapse.Multi-category ordered Logistic regression model showed that macrosomia (OR 2.469,95％ CI 1.029-5.927),parity ≥ 2 (OR 2.730,95％ CI 1.929-3.864),vaginal delivery (OR 43.257,95％ CI 25.505-73.353) and emergent cesarean section (OR 2.139,95 ％ CI 1.266-3.615) were risk factors of vaginal prolapse.Conclusions:Purepera 6-8 weeks postpartum had a high proportion of mild vaginal prolapse.Vaginal delivery,macrosomia and multiple parturition were significantly contributed to vaginal prolapse.