Objective To assess the association between superficial perineal muscle trauma and perineal pain and dyspareunia. Materials and methods Prospective cohort study of 405 women with a spontaneous vaginal birth comparing an intact perineum and first-degree perineal trauma group ( n = 205) with a second-degree perineal trauma and episiotomy group ( n = 200). Perineal pain was measured at 2 days, 10 days, 7 weeks, 3 months and 6 months postpartum. Dyspareunia was assessed at 7 weeks, 3 months and 6 months postpartum. Results All second-degree perineal traumas and episiotomies involved damage to the bulbospongiosus muscle (BSM), but not always to the superficial transverse perineal muscle (STPM). In case of second-degree trauma or episiotomy, the odds of pain at 10 days and dyspareunia at 6 months postpartum were four- and five-fold greater, respectively, than if the perineum had remained intact or suffered a first-degree perineal trauma [OR 4.4 (95% CI: 2.8–6.9) and OR 5.5 (95% CI: 2.8–10.9), respectively]. When comparing injuries where > 50% BSM ± STPM against those with < 50% BSM torn, pain was significantly higher at 10 days postpartum [OR 1.9 (95% CI: 1.1–3.6], with no difference at 7 weeks, while dyspareunia was significantly higher at 6 months postpartum [OR 3.3 (95% CI: 1.4–7.8)]. There was no difference in perineal pain or dyspareunia when comparing first-degree with < 50% BSM traumas. Conclusion When perineal muscle trauma encompasses > 50% BSM ± STPM, perineal pain and dyspareunia persisted until 10 days and 6 months postpartum, respectively.

中文翻译：

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与会阴浅层肌肉损伤相关的产后会阴痛和性交痛：一项队列研究

目的探讨会阴浅表肌外伤与会阴痛、性交痛的相关性。材料和方法 对 405 名自然阴道分娩的女性进行前瞻性队列研究，比较完整会阴和一级会阴外伤组 (n = 205) 与会阴二级外伤和会阴切开术组 (n = 200)。在产后 2 天、10 天、7 周、3 个月和 6 个月测量会阴疼痛。在产后 7 周、3 个月和 6 个月评估性交困难。结果 所有二度会阴外伤和会阴切开术均涉及球海绵体肌 (BSM) 损伤，但并不总是会阴浅横肌 (STPM) 损伤。在二级创伤或会阴切开术的情况下，产后 10 天疼痛和 6 个月性交困难的几率分别增加四倍和五倍，会阴保持完整或遭受一级会阴外伤 [OR 4.4 (95% CI: 2.8–6.9) 和 OR 5.5 (95% CI: 2.8–10.9)]。当将 > 50% BSM ± STPM 的损伤与 <50% BSM 撕裂的损伤进行比较时，产后 10 天的疼痛显着更高 [OR 1.9（95% CI：1.1-3.6]，在 7 周时没有差异，而性交痛则为产后 6 个月显着更高 [OR 3.3 (95% CI: 1.4–7.8)]。将一级创伤与 < 50% BSM 创伤进行比较时，会阴疼痛或性交痛没有差异。结论 当会阴肌肉创伤大于 50% BSM ± STPM、会阴疼痛和性交困难分别持续到产后 10 天和 6 个月。8–10.9），分别]。将> 50% BSM ± STPM 的损伤与< 50% BSM 撕裂的损伤进行比较时，产后 10 天时疼痛显着升高 [OR 1.9 (95% CI: 1.1–3.6]，第 7 周时无差异，而性交痛则为产后 6 个月显着更高 [OR 3.3 (95% CI: 1.4–7.8)]。将一级创伤与 < 50% BSM 创伤进行比较时，会阴疼痛或性交痛没有差异。结论 当会阴肌肉创伤大于 50% BSM ± STPM、会阴疼痛和性交困难分别持续到产后 10 天和 6 个月。8–10.9），分别]。当将 > 50% BSM ± STPM 的损伤与 <50% BSM 撕裂的损伤进行比较时，产后 10 天的疼痛显着更高 [OR 1.9（95% CI：1.1-3.6]，在 7 周时没有差异，而性交痛产后 6 个月显着更高 [OR 3.3 (95% CI: 1.4–7.8)]。将一级创伤与 < 50% BSM 创伤进行比较时，会阴疼痛或性交困难没有差异。结论 当会阴肌肉创伤大于 50% BSM ± STPM、会阴疼痛和性交困难分别持续到产后 10 天和 6 个月。而性交困难在产后 6 个月时显着升高 [OR 3.3 (95% CI: 1.4–7.8)]。将一级创伤与 < 50% BSM 创伤进行比较时，会阴疼痛或性交痛没有差异。结论 当会阴肌肉损伤大于 50% BSM ± STPM 时，会阴疼痛和性交痛分别持续到产后 10 天和 6 个月。而性交困难在产后 6 个月时显着升高 [OR 3.3 (95% CI: 1.4–7.8)]。将一级创伤与 < 50% BSM 创伤进行比较时，会阴疼痛或性交痛没有差异。结论 当会阴肌肉损伤大于 50% BSM ± STPM 时，会阴疼痛和性交痛分别持续到产后 10 天和 6 个月。