Background: Pelvic floor dysfunction (PFD) seriously affects the patients' quality of life, and its incidence is closely related to pregnancy and delivery. Pelvic floor muscle training (PFMT) is a conservative treatment of PFD. For decades, different researchers have conducted PFMT research on different female groups. However, the efficacy of PFMT for pregnant and postpartum women is controversial. Therefore, this article aimed to systematic review the efficacy of PFMT for them. This article reviewed the relationship between the occurrence and development of PFD during pregnancy and delivery, and the effect of PFMT on PFD in pregnant and postpartum women. Method: We used the keywords of "pelvic floor dysfunction" and "pelvic floor muscles training", and focused on the study of PFMT during pregnancy and postpartum. Finally, 54 related studies were selected, including randomized controlled trials, quasi experimental trials, observational studies, longitudinal cohort studies, cross-sectional studies, and systematic reviews. Result: During pregnancy, PFMT can prevent the occurrence of PFD in late pregnancy and early postpartum, and in the early postpartum period, PFMT can improve the symptoms of PFD. PFMT has a protective effect on the pelvic floor without obvious negative effects. However, PFMT has not been popularized in pregnant and postpartum women. And its beneficial effects cannot be maintained for a long time if women cannot insist on it for a long time. Conclusion:The popularization and standard guidance of PFMT during the pregnancy and postpartum period should be strengthened vigorously in hospital. The development of a personalized PFMT program according to the individual situation of pregnant and postpartum women can improve the pelvic floor symptoms and their quality of life of women.

Background The change in the characteristics of the gut microbiota is linked to gestational diabetes mellitus (GDM). However, whether and how the gut microbiota‐derived metabolites change in GDM is uncertain. Here, we aimed to determine associations between the gut microbiota‐derived metabolites and GDM. Methods Using targeted metabolomics approaches, 7 types of short‐chain fatty acids (SCFAs), 38 types of bile acids (BAs), and 5 types of trimethylamine N‐oxide (TMAO), and its derivatives of serum samples were obtained from pregnant women with GDM (n = 24), and healthy pregnant controls (HC, n = 28) were detected to identify the metabolic signature of GDM to investigate the potential biomarkers. Moreover, we assessed the associations between gut microbiota‐derived metabolites and clinical parameters. Results In our study, the gut microbiota‐derived metabolites signatures were significantly different between GDM and HC. Quantitative results showed the levels of isobutyric acid, isovaleric acid, valeric acid, caproic acid, GUDCA, THDCA + TUDCA, and LCA‐3S were significantly higher in GDM, but the level of TMAO and its derivatives did not change significantly. Some altered gut microbiota‐derived metabolites were significantly correlated with glucose and lipid levels. Receiver‐operating characteristic (ROC) analysis of generalized linear models showed that gut microbiota‐derived metabolites may be potential biomarkers of GDM. Conclusion This study highlights gut microbiota‐derived metabolites alterations in GDM and correlation of the clinical indicators, which provides a new direction for future studies aiming to novel serum biomarker for early detection or target of drug therapy of GDM.

Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.

No abstract