Postpartum pelvic floor rehabilitation treatment time
Postpartum pelvic floor rehabilitation
The female pelvic floor is mainly composed of muscles and fascia that close the pelvic outlet. Just like a hammock, it supports pelvic organs such as bladder, uterus and rectum, and maintains many physiological functions such as urination, defecation and sexual life.
However, during pregnancy and delivery, the pelvic floor tissue is subjected to different degrees of compression and delivery injury, which inevitably affects the pelvic floor function, and in severe cases, pelvic floor dysfunction will occur. That is to say, the elasticity of pelvic floor tissue becomes worse, the contraction force and support force of muscles are insufficient, and the organs in pelvic cavity cannot be fixed in the normal position, resulting in corresponding dysfunction. Mild symptoms include vaginal relaxation, decreased quality of sexual life, abdominal distension, frequent urination, urine leakage when coughing, constipation and so on. In severe cases, urinary incontinence, uterine prolapse, bladder prolapse, pelvic pain and other diseases have brought unspeakable pain.
Whether vaginal delivery or cesarean section, it will inevitably cause different degrees of damage to pelvic floor muscles during pregnancy. If cesarean section is performed because of the failure of vaginal trial delivery, the pelvic floor muscles and peripheral nerves may be squeezed more during vaginal trial delivery, resulting in pelvic floor dysfunction.
The difference between vaginal delivery and cesarean section is that the symptoms of lower urethra are more obvious in a short time after delivery, and the symptoms of lower urethra are more likely to appear in a year after delivery than in a new mother after cesarean section. But after a year, this difference will disappear.
However, you don't know what will happen to those cesarean section women who have suffered pelvic floor injury after pregnancy ... If you don't carry out rehabilitation training or treatment in time, there will be various pelvic floor dysfunction diseases such as pelvic floor muscle relaxation and urinary incontinence after delivery. About 60% of parturients can naturally recover pelvic floor muscle and nerve function after delivery, but about 30%-40% of parturients still have pelvic floor dysfunction diseases such as urinary incontinence and vaginal prolapse.
Did you do the right thing in the golden period of postpartum pelvic floor rehabilitation?
During pregnancy, with the increase of fetus and uterus weight, the pelvic floor tissue is compressed for a long time, which leads to the deformation of pelvic floor muscle fibers and the decrease of muscle tension. The change of hormone level during pregnancy changes the collagen metabolism of pelvic floor connective tissue, which leads to the weakening of pelvic floor supporting structure. During childbirth, the release of relaxation hormone and the excessive extension and expansion of the birth canal directly lead to perineal laceration and levator ani injury, and then destroy the pelvic floor tissue, even lead to unstable joint dislocation of the pelvis, which affects the position and function of various organs. The oppression during pregnancy makes it impossible for cesarean section to completely avoid the damage of pelvic floor function. A large number of research data at home and abroad show that at least 30% of women will have pelvic floor dysfunction after delivery. If rehabilitation treatment is not carried out in time, a series of serious symptoms will appear with age and second child pregnancy.
Therefore, pregnant women must make some positive preparations to ensure their quality of life after delivery in the future. 42 days after delivery, pelvic floor function should be checked routinely. If there are pelvic floor dysfunction problems such as pelvic floor muscle relaxation, vaginal wall bulging, stress urinary incontinence, etc., timely examination and rehabilitation should be carried out.
Three months after delivery is the best time for pelvic floor rehabilitation, otherwise, with the increase of age, it will not only increase the difficulty of treatment, but also increase the incidence of pelvic floor dysfunction such as uterine prolapse, urinary incontinence and sexual dysfunction. Therefore, it is a wise choice for every mother to pay attention to pelvic floor function examination and carry out pelvic floor rehabilitation as soon as possible.
What should postpartum pelvic prolapse pay attention to?
The uterus is an organ that produces menstruation and gives birth to the fetus. It is located in the center of the pelvic cavity, between the bladder and rectum. However, due to various reasons, many new mothers will have uterine prolapse after delivery, which is really worrying. Understand that the normal uterus with uterine prolapse is located in the center of pelvic cavity, with bladder in front, rectum in back and vagina at the lower end. It is a hollow organ, shaped like an inverted pear. The uterus can be divided into three parts: the bottom, the body and the neck. The stenosis of the lower part of uterus is isthmus, which gradually expands during pregnancy and forms the lower part of uterus during labor. At the same time, the uterine wall is elastic, which will increase with the growth of the fetus after pregnancy, and the uterus will gradually shrink back to its original size after delivery. That uterine prolapse means that the uterus descends from the normal position along the vagina, the external opening of the cervix reaches below the level of the ischial spine, and even the uterus completely leaves the vaginal opening. What causes uterine prolapse? 1, childbirth injury is the main cause of uterine prolapse. During delivery, especially those assisted by vaginal surgery or prolonged in the second stage of labor, the pelvic floor muscles, fascia and uterine ligaments are overstretched, the tension is reduced, and even tears appear, which creates conditions for uterine prolapse. 2. Uterine prolapse caused by improper force during delivery. Some parturients have not fully opened the uterine orifice, that is, they hold their breath prematurely, especially in urgent labor or dystocia. 3. The premature use of corsets, heavy physical labor, strenuous exercise and prolonged squatting by new mothers may also lead to uterine prolapse. 4. Multiple deliveries will also increase the chance of pelvic floor tissue injury. 5, the new mother after childbirth is weak, if postpartum cough, constipation, increased abdominal pressure will also cause uterine prolapse. Identification of main symptoms of uterine prolapse The main symptoms of uterine prolapse include vaginal mass prolapse, heaving sensation or lumbago, abnormal urination, and increased leucorrhea. The uterine prolapse is 3 degrees, so new mothers should be careful. 1 degree means that the level of the external cervix is lower than that of the sciatic spine, and the cervix and uterus are still in the vagina, not reaching the hymen margin. New mothers with this degree of uterine prolapse need not be too nervous, just pay attention to rest. The second degree means that the cervix has slipped out of the vaginal opening and the uterine body or part of the uterine body is still in the vagina. Second-degree uterine prolapse can be divided into mild and severe types: mild: the cervix is separated from the vaginal opening and the uterus is still in the vagina. Severe: Most or all of the cervix, part of uterus and anterior vaginal wall are separated from the vaginal orifice. The third degree refers to the whole uterus and cervix coming out of the vagina. Prevention of uterine prolapse, starting from 1 every day, late marriage and late childbirth, to prevent too many and too dense births; 2, more exercise during pregnancy is helpful for smooth delivery and reduce birth injuries during delivery; 3. Do not engage in heavy physical labor during menstruation, pregnancy, puerperium and lactation, especially after childbirth, and pay attention to rest and recovery; 4. Actively treat chronic cough and habitual constipation; 5, new mothers can do postpartum exercise to promote physical recovery.