Objective:

To analyze the relationship between delivery mode and symptoms and signs of pelvic organ prolapse (POP) evaluated by four-dimensional pelvic floor ultrasonography.

Methods:

A total of 578 women who underwent gynecological ultrasonography were enrolled in this study. Fertility history and clinical data were obtained from clinical questionnaires and gynecologists. The data were collected by four-dimensional pelvic ultrasound. Wome

n were divided into four groups and the symptoms and signs of POP were compared among these groups. To observe prolapse symptoms

visual analogue scale (VAS) score for prolapse bother

International Continence Society (ICS) pelvic organ prolapse quantification (POP-Q) and ultrasound findings of anterior

middle and posterior compartment prolapse were used.

Results:

Nulliparae showed the lowest probability of POP (POP-Q: cystoptosis of 15.6%

metroptosis of 11.1%

rectocele of 20.0%; ultrasound: 6.7%

8.9%

13.3% in sequence)

followed by caesarean section (POP-Q: 24.1%

6.4%

24.0% in sequence; ultrasound: 13.0%

8.5%

25.9% in sequence). Women with history of using forceps had the highest probability of POP (POP-Q: 59.6%

50.8%

63.2% in sequence; ultrasound: 45.6%

52.6%

42.1% in sequence). Compared with the cesarean section group

the adjusted odds ratio was 2.4 (95%CI: 1.30-4.59) and 3.2 (95%CI: 1.65-6.12) in the normal vaginal delivery group and forceps group.

Conclusion:

There is a significant correlation between vaginal delivery and POP. Four-dimensional pelvic floor ultrasonography

which has the advantages of easy-operation

repeatibility

no radiation

can be used as the preferred method of diagnosis of POP.