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| Based on Perineal Ultrasound Combined with Serum Fibulin-3,A Prediction Model for Postpartum Pelvic Floor Dysfunction of Parturients Undergoing Analgesia in Water Delivery was Established |
| Qin Zhenzhen, Zhang Lulu, Zhang Xueqin |
| Department of Obstetrics and Gynecology,Anyang People's Hospital,Anyang,Henan 455000 |
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Abstract Objective The aim of this study was to investigate the value of transperineal ultrasound（TPUS） parameters combined with serum Fibulin-3 in predicting postpartum pelvic floor dysfunction（PFD） in women who experienced pain relief during water birth,and to construct a combined predictive model.Methods A total of 150 women who underwent water birth analgesia and were admitted to our hospital from January 2023 to June 2024 were selected as study subjects.Based on the pelvic floor function assessment results at 6~8 weeks postpartum,they were divided into an impaired group （n=45） and a normal group（n=105）.Serum Fibulin-3 levels were collected postpartum,and parameters such as the angle of progression（AOP） and fetal head direction angle（HD） were measured via perineal ultrasound.Multivariate logistic regression analysis was performed,and the predictive efficacy of each indicator and the combined model was evaluated using the receiver operating characteristic（ROC）curve.Results The obstructed group exhibited significantly higher rates of PFD family history（12,26.67%）,parity≥2（19,42.22%）,perineal laceration（12,26.67%）,prolonged active phase of the first stage of labor（10,22.22%）,prolonged second stage of labor（17,37.78%）,and neonatal body weight（3437.86±414.05）g compared to the normal group（all P<0.05）.The TIMP-1 level in the obstructed group were significantly lower than those in the normal group （all P<0.05）.The AOP in the obstructed group was significantly smaller than that in the normal group,while the HD,HPD,and mLA in the obstructed group were significantly larger than those in the normal group（all P<0.05）.Multivariate logistic regression analysis revealed that TIMP-1,Fibulin-3,and AOP were protective factors for postpartum PFD,whereas HD,HPD,and mLA enlargement were independent risk factors.The ROC curve showed that the AUC of the combined index reached 0.862,with sensitivity and specificity of 75.56% and 85.71%,respectively（all P<0.05）.Conclusion The combined perineal ultrasound parameters and serum Fibulin-3 model demonstrated significant predictive value for postpartum pain distress（PFD） in women undergoing water birth analgesia,providing a theoretical basis for early clinical prevention.
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Received: 01 April 2026
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2026, Vol. 46 
