基于盆底超声参数构建剖宫产后盆底功能障碍的风险预测模型OA

Objective To investigate the predictive value of a risk prediction model constructed based on pelvic floor ultrasound parameters for postoperative pelvic floor dysfunction(PFD)after cesarean section.Methods A total of 300 parturients who underwent cesarean section from March 2022 to March 2024 were selected.They were divided into the PFD group and the non-PFD group based on whether PFD occurred at 12 months after delivery.The occurrence of PFD after cesarean section was observed,and the general data,biochemical indicators[serum relaxin,insulin-like growth factor-1(IGF-1)],and pelvic floor ultrasound parameters of the two groups were compared.Multivariate logistic regression analysis was used to analyze the independent influencing factors of PFD after cesarean section.Based on this,a risk prediction model was constructed,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve and calibration curve.Results Among the 296 parturients who completed the 12-month follow-up,51 patients developed PFD(all presenting as stress urinary incontinence),with an incidence rate of 17.23％(51/296).Serum relaxin,serum IGF-1,urinary leakage symptoms during pregnancy,bladder neck mobility,pregnancy-induced constipation,regular pelvic floor muscle training after delivery,and bladder neck funnel formation were all independent influencing factors for PFD after cesarean section(P<0.05).ROC curve analysis showed that the areas under the curve(AUC)for serum relaxin,serum IGF-1,and bladder neck mobility in predicting PFD after cesarean section were 0.768,0.757,and 0.771,respectively(P<0.05),and that the AUC of the risk prediction model constructed based on the above influencing factors was 0.892(95％CI:0.849,0.936);calibration curve analysis showed that the model had a high calibration accuracy,and demonstrated good consistency and goodness-of-fit between the predicted values and the observed values.Conclusion Constipation during pregnancy,urinary leakage symptoms during pregnancy,serum relaxin,bladder neck mobility,bladder neck funnel formation,regular pelvic floor muscle training after delivery,and serum IGF-1 are all independent influencing factors for the occurrence of PFD after cesarean section.Based on these factors,a risk prediction model has been established,which has high discrimination and accuracy,and possesses good predictive performance.