Objective  To explore the influence of combination of misoprostol and pelvic floor muscle exercise on full-term pregnancy induced labor process and postpartum pelvic floor muscle function.

Methods   Puerperae with full-term pregnancy induced labor in Women and Children’ s Hospital of Ningbo University in Zhejiang Province were selected from September 2022 to September 2024. According to the random number table method, the enrolled subjects were divided into the control group (intravaginal administration of misoprostol) and the combined group (pelvic floor muscle exercise  on the basis of the control group). The induced labor process, pregnancy outcomes, postpartum pelvic floor muscle function, occurrence of postpartum pelvic floor dysfunction and maternal satisfaction and adverse reactions were compared between two groups.

Results  A total of 204 cases of labor induction in full-term pregnancy were enrolled in this study, including 102 cases in the control group and 102 cases in the combined group. During study, no patient was dropped out in the two groups. The first and the second stages of labor in the combined group were significantly shortened compared with those in the control group (P ﹤ 0.05), and the vaginal delivery rate in the combined group was significantly enhanced compared to the control group (P﹤0.05). There were no statistical differences in the third stage of labor, incidence rate of neonatal asphyxia, incidence rate of fetal distress and postpartum hemorrhage volume between groups (P>0.05). At 42 days after delivery, compared with the control group, the rate of “grade 5” in modified Oxford muscle strength grading method was significantly increased in the combined group while the rate of “grade 3” was significantly decreased (P﹤0.05), the incidence of postpartum pelvic floor dysfunction was significantly decreased (P ﹤ 0.05), and the total maternal satisfaction rate was obviously elevated (P ﹤ 0.05). No statistical differences were exhibited in the incidence rates of adverse reactions between both groups (P>0.05).

Conclusion  Pelvic floor muscle exercise combined with misoprostol during labor induction of puerperae with full-term pregnancy can shorten the stage of labor, improve the pregnancy outcomes and postpartum pelvic floor muscle function. In addition, it can effectively prevent postpartum pelvic floor dysfunction and has high maternal satisfaction.

1.丁菊花, 苏敏. 宫颈分泌物IGFBP-1在瘢痕子宫足月妊娠引产中的预测价值[J]. 中国妇产科临床杂志, 2020, 21(3): 287-288. [Ding JH, Su M. The predictive value of cervical secretions IGFBP-1 in inducing labor in full-term pregnancy with cicatricial uterus[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2020, 21(3): 287-288.] DOI: 10.13390/j.issn.1672-1861.2020.03.023.

2.Hermesch AC, Kernberg AS, Layoun VR, et al. Oxytocin: physiology, pharmacology, and clinical application for labor management[J]. Am J Obstet Gynecol, 2024, 230(3S): S729-S739. DOI: 10.1016/j.ajog.2023.06.041.

3.昂正兰, 王琳, 闻明. 可控释地诺前列酮栓与米索前列醇及Foley尿管用于足月妊娠促宫颈成熟及引产的效果及安全性比较[J]. 中国妇产科临床杂志, 2022, 23(3): 257-259. [Ang ZL, Wang L, Wen M. Comparison of efficacy and safety of controlled-release Dinoprostol supposition, misoprostol and Foley urinary tube for cervical maturation and labor induction in full-term pregnancy[J]. Chinese Clinical Journal of Obstetrics and Gynecology, 2022, 23(3): 257-259.] DOI: 10.13390/j.issn.1672-1861.2022.03.011.

4.任亚娟, 林青, 孙青凤, 等. 脱花煎加减配合米索前列醇治疗不完全流产的效果[J]. 中华中医药学刊, 2023, 41(2): 205-209. [Ren YJ, Lin Q, Sun QF, et al. Effect of modified Tuohua decoction with miepristone in treatment of incomplete abortion[J]. Chinese Archives of Traditional Chinese Medicine, 2023, 41(2): 205-209.] DOI: 10.13193/j.issn.1673-7717.2023.02.046.

5.Toloza SCM, Cogollo AFV, García KMP. Pelvic floor training to prevent stress urinary incontinence: a systematic review[J]. Actas Urol Esp (Engl Ed), 2024, 48(4): 319-327. DOI: 10.1016/j.acuroe.2024.01.007.

6.曹冬如, 陈磊, 马瑶, 等. 米索前列醇促宫颈成熟1天后低宫颈评分的处理方法比较[J]. 中国性科学, 2020, 29(2): 75-78. [Cao DR, Chen L, Ma Y, et al. The comparison of 3 induction managements on term pregnant women with low bishop scores after one-day misoprostol induction[J]. Chinese Journal of Sexual Sciences, 2020, 29(2): 75-78.] DOI: 10.3969/j.issn.1672-1993.2020.02.022.

7.张娟, 王丹丹, 李淑华, 等. 米索前列醇联合缩宫素对足月引产产程、Bishop宫颈评分及妊娠结局影响[J]. 中国计划生育学杂志, 2023, 31(10): 2376-2379. [Zhang J, Wang  DD, Li SH, et al. Effects of misoprostol combined with oxytocin for induction labor of full-term pregnancy on the duration of labor,bishop score,and pregnancy outcomes[J]. Chinese Journal of Family Planning, 2023, 31(10): 2376-2379.] DOI: 10.3969/j.issn.1004-8189.2023.10.021.

8.陈娟, 任远, 朱兰. 改良牛津肌力分级和盆底表面肌电评估女性压力性尿失禁患者盆底肌功能的相关性[J]. 中华医学杂志, 2020, 100(37): 2908-2912. [Chen J, Ren Y, Zhu L. Correlation between modified oxford grading scale and pelvic floor surface electromyography in assessment of pelvic floor muscle function in female patients with stress urinary incontinence[J]. Chinese Medical Journal, 2020, 100(37): 2908-2912.] DOI: 10.3760/cma.j.cn112137-20200301-00525.

9.花卉, 许晨莹, 刘金凤. 盆底肌训练时机对高龄初产妇产后盆底肌张力及性功能的影响[J]. 中华妇幼临床医学杂志（电子版）, 2024, 20(3): 284-291. [Hua H, Xu CY, Liu JF. Effect of pelvic floor muscle training timing on postpartum pelvic floor muscle tension and sexual function of elderly primiparae[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics (Electronic Edition), 2024, 20(3): 284-291.] DOI: 10.3877/cma.j.issn.1673-5250.2024.03.007.

10.李婷婷, 吴丹, 孙博. 母血和羊水IL-6水平对足月胎膜早破组织学绒毛膜羊膜炎的预测价值及其对妊娠结局的影响 [J]. 中国妇产科临床杂志, 2023, 24(3): 293-294. [Li TT, Wu  D, Sun B. The predictive value of IL-6 levels in maternal blood and amniotic fluid for premature rupture of fetal membrane and its influence on pregnancy outcome[J]. Chinese Clinical Journal of Obstetrics and Gynecology, 2023, 24(3): 293-294.] DOI: 10.13390/j.issn.1672-1861.2023.03.022.

11.Goldberg AB, Fulcher IR, Fortin J, et al. Mifepristone and misoprostol for undesired pregnancy of unknown location[J]. Obstet Gynecol, 2022, 139(5): 771-780. DOI: 10.1097/AOG.0000000000004756.

12.Szpot P, Wachełko O, Zawadzki M. Forensic toxicological aspects of misoprostol use in pharmacological abortions[J]. Molecules, 2022, 27(19): 6534. DOI: 10.3390/molecules27196534.

13.Machado LO, Taquette SR. The use of misoprostol in the termination of pregnancy: a review of studies carried[J]. Cien Saude Colet, 2022, 27(8): 3079-3090. DOI: 10.1590/1413-81232022278.03102022.

14.胡婷, 王璐璐. 产前盆底锻炼联合产后服用举元煎颗粒剂对预防产后盆底障碍性疾病的临床效果[J]. 中华全科医学, 2020, 18(1): 85-87, 149. [Hu T, Wang LL. Clinical study on prenatal pelvic floor exercise combined with postpartum juyuan decoction granule in preventing postpartum pelvic floor dysfunction[J]. Chinese Journal of General Practice, 2020, 18(1): 85-87, 149.] DOI: 10.16766/j.cnki.issn.1674-4152.001175.

15.Kaur S, Kaur S. Recent advances in vaginal delivery for the treatment of vulvovaginal candidiasis[J]. Curr Mol Pharmacol, 2021, 14(3): 281-291. DOI: 10.2174/1573405616666200621200047.

16.de Waal AC, van Amstel T, Dekker JJML, et al. Outcome after vaginal delivery of women with a previous medical history of surgically corrected anorectal malformations: a systematic review[J]. BMC Pregnancy Childbirth, 2023, 23(1): 94. DOI: 10.1186/s12884-023-05389-9.

17.朱小莹, 胡明钰, 宋海新, 等. 盆底肌生物反馈电刺激联合抗阻夹腿训练治疗产后压力性尿失禁的疗效观察[J]. 中华物理医学与康复杂志, 2024, 46(7): 644-647. [Zhu XY, Hu MY, Song HX, et al. Effect of pelvic floor muscle biofeedback electrical stimulation combined with anti-resistance leg clamp training on postpartum stress urinary incontinence[J]. Chinese Journal of Physical Medicine and Rehabilitation, 2024, 46(7): 644-647.]DOI: 10.3760/cma.j.issn.0254-1424.2024.07.013.

18.Schütze S, Heinloth M, Uhde M, et al. The effect of pelvic floor muscle training on pelvic floor function and sexuality postpartum. A randomized study including 300 primiparous[J]. Arch Gynecol Obstet, 2022, 306(3): 785-793. DOI: 10.1007/s00404-022-06542-z.

19.Sheng Y, Carpenter JS, Ashton-Miller JA, et al. Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review[J]. BMC Womens Health, 2022, 22(1): 161. DOI: 10.1186/s12905-022-01742-w.