Application of Transperineal Pelvic Floor Ultrasound in Changes of Pelvic Floor Structure and Function Between Pregnant and Non-Pregnant Women.

Objective: To evaluate the changes of pelvic floor tissue structure and function between pregnant and non-pregnant women from the view of transperineal pelvic floor ultrasound. Methods: Thirty-eight cases of women with a second singleton pregnancy and thirty-two cases of women with a first singleton pregnancy underwent transperineal pelvic floor ultrasound, and their results were compared with forty-two cases of healthy non-pregnant women. Results: The differences of bladder neck descent (BND), rectal ampulla distance and levator hiatus area (LHA) among the three groups were statistically significant (P<0.05), and the differences of BND, rectal ampulla distance, LHA between the women with a second singleton pregnancy group and non-pragnent group were statistically significant (P<0.05). The BND, retrovesical angle at rest (RVA-R) and retrovesical angle underwent Valsalva maneuver (RVA-V) in the group of stress urinary incontinence (SUI) during pregnancy were larger than those in non-SUI group, with significant difference (P<0.05), especially BND and RVA-V (P = 0.00). Conclusion: Transperineal pelvic floor ultrasound has a high resolution of pelvic floor structure and function changes during pregnancy, and can dynamically evaluate pelvic floor function, providing a theoretical basis for early diagnosis and prevention of female pelvic floor dysfunction (FPFD) in subsequent pregnancies.

Relationship between 3D Power Doppler Ultrasound and Serum MMP-2 and Ang-2 Levels in Pregnant Women with Preeclampsia.

OBJECTIVE: To explore the relationship between 3D power Doppler ultrasound (3D-PDU) and serum MMP-2 and Ang-2 levels in pregnant women with preeclampsia (PE). STUDY DESIGN: Comparative analytical study. PLACE AND DURATION OF STUDY: The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, China, from October 2017 to January 2020. METHODOLOGY: One hundred and thirty-four pregnant women with PE were selected as the research subjects, with 67 cases in mild group and 67 cases in severe group. Sixty-seven healthy primigravidas were selected as normal control group. Serum MMP-2 and Ang-2 were detected. All subjects underwent prenatal 3D-PDU examination, and VI, FI and VFI were measured. RESULTS: Compared to normal control group, serum MMP-2 and Ang-2 levels of mild group and severe group decreased successively (all p <0.001); VI, FI, and VFI of mild group and severe group decreased successively (both p <0.001). Pearson correlation analysis showed that serum MMP-2 in pregnant women with PE was positively correlated with VI, FI, VFI (r = 0.940, p <0.001, r = 0.938, p <0.001, and r = 0.921, p <0.001, respectively); and serum Ang-2 was positively correlated with VI, FI, VFI (r = 0.958, p <0.001; r = 0.960; p <0.001; r = 0.945, p <0.001, respectively). CONCLUSION: 3D-PDU has a certain application value in the diagnosis of pregnant women with PE, variation tendency of VI, FI and VFI detected by 3D-PDU is closely associated with serum MMP-2 and Ang-2 levels. Key Words: Preeclampsia, Pregnant women, MMP-2, Ang-2, 3D power Doppler ultrasound (3D-PDU).

[Outcome and prognosis of isolated mild fetal ventriculomegaly in uterus].

OBJECTIVE: To investigate outcome and prognosis of isolated mild fetal ventriculomegaly (IMV) of fetus in uterus. METHODS: From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV (transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities) were studied prospectively, which were divided into two groups: 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up. RESULTS: (1) The overall incidence of IMV was 0.08% (148/18 200). The rate of bilateral ventriculomegaly were 20% (20/99) in group A and 51% (25/49) in group B, which reached statistical difference (P < 0.05). (2) Prognosis of fetus: 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41.7% (58/139), regressed in 7.9% (11/139), remained stable in 36.7% (51/139) and progressed in 13.7% (19/139). Five cases in group A and 11 cases in group B present progress, which reached significantly difference (P < 0.05). (3) One hundred and eleven cases infant were followed up for 5-12 months, the rate of psycho-motor developmental delay was 5.4% (6/111). The rate of neuro-developmental delay in progressed group (3/15) was higher than 2.5% (1/40) in resolved group, 0 (0/8) in regressed group and 4.2% (2/48) in remained stable group, which reached significantly difference (P < 0.05). CONCLUSIONS: About 85% of cases of IMV resolved, regressed or remained stable in utero would exhibited good prognosis. IMV with a transverse atrial size ≥ 12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.