注腸造影検査に引き続いて行う簡易排便造影の試み

Objective To evaluate the morphology of pelvic muscle in infants with rectovestibular fistula. Methods A total of 20 infants with rectovestibular fistula aged 3-5 months received the examinations of radiology, barium enema and pelvic floor magnetic resonance imaging(MRI). The follow-up period was 1 year. Two infants were complicated by tethord cord syndrome. Three infants were complicated by dilations of rectum and sigmoid colon. There were 10 girls aged 3-6 months in control group. Results In control group, no difference existed between the thickness of bilateral external anal sphincter[left:(1.58±0.12)mm, right:(1.57±0.14)mm], puborectalis[left:(1.47±0.13)mm, right:(1.45±0.09)mm], ani levator[left:(1.75±0.18)mm, right:(1.72±0.22)mm]. The thickness of bilateral external anal sphincter[left:(1.32±0.39)mm, right:(1.21±0.35)mm], puborectalis[left:(1.18±0.33) mm, right:(1.06±0.35) mm] in infants with rectovestibular fistula were thinner than those in control group. The thickness of bilateral ani levator(left: 1.53±0.37 mm, right: 1.53±0.29 mm)in infants with rectovestibular fistula showed no difference from control group. Spearman's rank correlation analysis indicated sacral ratio(0.69±0.15) had no correlation with the thickness of external anal sphincter(left: r=0.361, P=0.118; right: r=0.150, P=0.527), puborectalis(left: r=-0.032, P=0.893; right: r=0.096, P=0.689)and ani levator(left: r=-0.082, P=0.732; right: r=-0.034, P=0.852). And the postoperative complications included difficult defecation(n=4), tethord cord syndrome(n=1) and dilations of rectum and sigmoid colon(n=3). Conclusions External anal sphincter, puborectalis and ani levator are bilaterally symmetric in healthy infants. Ani levator is normal in infants with rectovestibular fistula. External anal sphincter and puborectalis are weaker, but there is no dysfunction of defecation. The developments of external anal sphincter, puborectalis and ani levator have no correlation with sacral ratio. Key words: Congenital abnormalities; Rectum; Fistula

Objective To explore the clinical effect of pelvic floor muscle rehabilitation therapy to recover pelvic floor dysfunction.Methods 435 cases of 6-8 weeks postpartum urinary incontinence patients were chosen.The urinary incontinence questionnaire （ ICI-QSF） ,and Female Sexual Function Index questionnaire （ FSFI questionnaire） were used to detect maternal urinary incontinence （UI） investigation,pelvic organ prolapse （POP-Q） degree and quality of sexual life questionnaire.Ⅰ muscle,Ⅱ muscle strength and fatigue, vaginal and the change of dynamic pressure for pelvic floor functional change before and after Pelvic floor rehabilitation were compared.Pelvic floor mus-cle rehabilitation treatment included：imitation bioelectricity stimulus,biofeedback,scene reflection training and Kegel exercises.Results After pelvic floor muscle rehabilitation,pelvic floor function improved significantly,pelvic floor muscle strength increase, decrease fatigue, vaginal dynamic pressure rose significant difference：Electrical values （μV） before treatment （5.6 ±1.8）,after treatment（15.1 ±4.6）,t =3.6,P 〈0.05;Vaginal dynamic pressure （cmH2O） before treatment（48.7 ±11.0）,after treatment （86.3 ±5.1）cmH2O（t=7.2,P〈0.01）;Fatigue obvi-ously improved,（P〈0.01）,the effect of Urinary incontinence treatment is very obvious （t=5.6,P〈0.05）and pelvic organ prolapse improved significantly：Before treatment vaginal wall prolapse II degrees 63 people,after treat-ment 14 people,remission rate 82%,and Before treatment uterine prolapse 172 people,after treatment uterine pro-lapse 39 people,the response rate of 77.3% （P 〈0.01）,sexual function improved significantly：before treatment score is （78.00 ±20.45） and after treatment scores is （100.00 ±25.36）,t=8.6 （P〈0.01）.Conclusion Pelvic floor muscle rehabilitation effectively improve postpartum women pelvic floor function,can achieve the purpose of the treatment of urinary incontinence,improve pelvic organ prolapse and the quality of sex life. Key words: Urinary incontinence ; Pelvic floor disorders ; Postpartum period; Rehabilitation; Neurofeedback

To evaluate continuous improvement of portable domestic pelvic floor neuromuscular electrical stimulation on the pelvic floor function of patients with stress urinary incontinence after short-term pelvic floor electrophysiological treatment in hospital. Totally 60 women with stress urinary incontinence were recruited for this randomized controlled trial. The control group including a total of 30 patients, only received 4 weeks pelvic floor electrophysiological treatment in the hospital. Family consolidation treatment group (experimental group) including 30 patients, after 4-week treatment in hospital, received 12-week of pelvic floor neuromuscular electrical stimulation using portable electrical stimulator at home under the guidance of doctors. In post-treatment 6 months and 9 months, 1-hour pad test was measured for urine leakage, pelvic floor electrical physiological parameters were assessed, and subjective improvement of symptoms of urinary incontinence were evaluated. All these data were analysed to compare the effect of the two groups. In 9 months after treatment, average change of urine leakage, the control group and experiment group were (75±24)% versus (99±3)%, the difference was statistically significant (P<0.01). In the experiment group, strength of type I muscle (4.4±0.7), strength of type II muscle (4.8±0.4) and pelvic floor dynamic pressure [(96±12) cmH(2)O, 1 cmH(2)O=0.098 kPa] were better than those of control group [3.2±1.0, 4.3±0.9, (86±10) cmH(2)O, respectively], the differences were statistically significant (P<0.01). Subjective outcome, the control group and experiment group were (6.5±2.9) versus (1.8±1.7), subjective outcome between the two groups had significant difference (P<0.01). After short-term pelvic floor electrophysiological treatment in hospital, the portable domestic pelvic floor neuromuscular electrical stimulation in patients with stress urinary incontinence is helpful to continuous improvement of pelvic floor function.

Objective To evaluate the changes of pelvic floor structure and function quantitatively in different periods after taking total hysterectomy by transperineal pelvic ultrasound. Methods A total of 105 female patients who underwent ultrasound examination after hysterectomy at the Second Hospital of Lanzhou University from March 2016 to July 2017 were enrolled. Among them, 37 cases were 40-49 years old, 49 cases were 50-59 years old, 19 cases were over 60 years old; 29 cases were less than 1 years after hysterectomy, 33 cases were>1,≤5 years after hysterectomy, 28 cases were>5,≤10 years after hysterectomy, and 15 cases were over 10 years after hysterectomy. A total of 120 female volunteers from the Second Hospital of Lanzhou University who had not been diagnosed with pelvic floor dysfunction (PFD) were selected as the healthy control group without total hysterectomy or other pelvic floor surgery. All subjects were examined by pelvic floor ultrasound. The distance from the bladder neck to the lower edge of pubic symphysis (X), urethral angle (α), retrovesical angle (β), the distance from the lowest point from the rectal ampulla to the lower edge of pubic symphysis (D) and detrusor thickness under resting state and maximal Valsalva state were measured. And the urethral rotation angle (Rα) and bladder neck descent value (BND) were calculated. T test was used to compare the ultrasonic quantitative parameters between the total hysterectomy group and the healthy control group, and the detection rate of PFD was compared by Chi-square test between the patients of different age groups at different time after hysterectomy. Results The thickness of bladder detrusor in total hysterectomy group was significantly higher than that in healthy control group. The age of patients in the total hysterectomy group was older than that in the healthy control group, and the difference was statistically significant. At rest, compared with the subjects in the healthy control group, the βincreased, the X and D decreased in patients with total hysterectomy. The differences were significant. The α increased after hysterectomy, but the difference was not statistically significant. At maximum Valsalva state, compared with the subjects in the healthy control group, the α, β, Rα and BND all increased in the group of total hysterectomy, and the X and D decreased. The difference was statistically significant. The detection rate of PFD in 105 cases of total hysterectomy group was 60% (63/105), the detection rate of stress incontinence (SUI) was 33.3% (35/105), and the detection rate of pelvic organ prolapse (POP) was 36.2% (38/105). In POP, the detection rate of bladder prolapse, rectal prolapse and intestinal hernia was 18.1% (19/105), 10.5% (11/105) and 6.7% (7/105). SUI was the main occurrence of PFD within 1 year after total hysterectomy, and the detection rate was 48.3% (14/29). 10 years after operation, POP was the predominant occurrence of PFD, and the detection rate was 80.0% (12/15). There was no significant difference in the detection rate of PFD between different age groups after hysterectomy, indicating that the detection rate of PFD at different times after hysterectomy may not be closely related to the age of patients. Conclusion Transperineal pelvic floor ultrasonography can dynamically observe the changes of pelvic floor structure after total hysterectomy, and can evaluate PFD quantitatively after operation. Key words: Ultrasonography; Pelvic floor; Stress incontinence; Pelvic organ prolapse; Hysterectomy

Objective To investigate the value of evaluation of pelvic floor ultrasound in the transvaginal modified patch repair and sacrospinous ligament fixation in uterine prolapse patients. Methods Thirty-two patients with uterine prolapse were included in the retrospective study from March 2016 to January 2017 in Hangzhou maternity and child health care hospital. All patients were detected by pelvic floor ultrasound before operation and cured by vaginal patch bilateral sacral spine ligament fixation treatment after. Of them, 8 cases were complicated with cystocele and 3 cases with anorectal prolapse, and all the complications were treated at the same time. The observations of the change of position, shape and activity of the implant by transvaginal at rest, on maxium Valsalva and contraction, and the transperineal pelvic ultrasound were performed to evaluate the change of pelvic floor function and compare the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line (the horizontal line at the lower margin of the pubic bone), area of levator hiatus and the thickness of the puborectalis muscle before and after operation. Results The patches were observed 2D and 3D postoperatively by pelvic ultrasound. The U-shaped hyperecho could be clearly shown around the cervix and activity of patches were clearly shown. The observation of 32 cases of patients with pelvic viscera situation by the transperineal 2D and 4D pelvic ultrasound: the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line and the thickness of the puborectalis muscle enlarged after operation (0.65±1.85 vs 0.15±1.85, 2.80±1.10 vs -1.00±1.50, 0.60±1.90 vs -0.55±1.55, 0.51±0.24 vs 0.37±0.19) onmaxium valsalva, the area of levator hiatus decreased after operation (20.15±7.20 vs 29.00±9.50). The differences were both statistically significant (all P<0.05). Uterine prolapse were not found after operation. In the 8 cases with cystocele, 5 cases were cured and 3 cases were improved. And all the 3 cases of patients with anorectal prolapse were all cured. Conclusion Combined application of transvaginal and transperineal pelvic ultrasound can clearly show the suspension of the patch after the treatment of modified patch repair and Sacrospinous ligament fixation, which provide valuable imaging information in the evaluation of preoperative pelvic functionand postoperative therapeutic effect. Key words: Pelvic floor ultrasound; Uterine prolapse; Modified patch repair; Sacrospinous ligament fixation; Levator hiatus

Objective To investigate the outcomes of conventional pelvic floor rehabilitation combined with electrical stimulation and biofeedback for treatment of postpartum pelvic floor muscle dysfunction. Methods A total of 198 women diagnosed with pelvic floor muscle dysfunction after natural labor at our hospital between January 2014 and June 2014 were included in this study. According to personal intention, the patients were divided into the treatment group (n=99) and the control group (n=99). On day 42 postpartum, the control group received conventional pelvic floor rehabilitation (pelvic floor muscle exercise) , whereas the treatment group received electrical stimulation and biofeedback in addition to the conventional pelvic floor rehabilitation. Before treatment and at 3 months postpartum, the two groups of patients were measured for muscle strength of the pelvic floor. At 3 and 6 months postpartum, the vaginal resting pressure, vaginal squeezing pressure and duration of vaginal contractions of the two groups were examined. The incidences of urinary incontinence, pelvic organ prolapsed and sex satisfaction were compared between the two groups. Results Before treatment, the pelvic floor muscle strength did not differ significantly between the two groups (P>0.05). At 3 months postpartum, patients in the treatment group had higher pelvic floor muscle strength than the controls (P<0.05). At 3 and 6 months postpartum, the treatment group showed significantly higher vaginal resting pressure, vagina squeezing pressure, and longer duration of vaginal contractions, less urinary incontinence and better sex satisfaction (all P<0.05) , compared with the control group. At 6 months postpartum, the rate of pelvic organ prolapsed was 3.0% (3/99) in the treatment group vs 10.1% (10/99) in the control group, with statistically significant difference between two groups (χ2= 2.234, P<0.05). Conclusion Pelvic floor muscle exercise combined with electrical stimulation and biofeedback may yield better outcomes for treatment of postpartum pelvic floor muscle dysfunction. Key words: Biofeedback; Electrical stimulation; Pelvic floor dysfunction; Treatment outcomes

Objective To explore the diagnostic value of barium enema film for Hirschsprung’s disease (HD) and examine the correlation between radiological transition zone (TZ) and final pathology. Methods For this single-center cross-sectional study, a total of 56 patients with suspected HD undergoing barium enema and primary pull-through operations from January 2013 to January 2014 were reviewed. According to barium enema, full-thickness bowel wall biopsies were performed before and after 5 cm of transitional zone. And the gold standard was detecting ganglion cell by PGP9.5 staining. If aganglionosis was considered positive whereas ganglionosis negative. The diagnostic parameters of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of barium enema in the range of HD were analyzed by statistical software. Results Their average age was 13.7 months. The sensitivity of barium enema film was 86.9% and specificity 94.1%. The value of PPV was 94.6% and that of NPV 85.7%. Youden index was 81%. Consistency checking Kappa value was 0.804 (P<0.001). The diagnostic coincidence rate was 77.8% in short-segment HD, 88.9% in normal-segment HD and 66.7% in long-segment HD. Conclusions With a high diagnostic predictive value for HD, barium enema film is useful for confirming the involvement extent of aganglionosis bowel. Key words: Hirschsprung’s disease; Barium enema; Child

Pregnancy and vaginal delivery may cause urinary incontinence (UI) in some women, which can impact on their quality of life. Pelvic floor muscles training (PFMT) is a safe and effective intervention for preventing UI associated with pregnancy. The aim of this evidence-implementation project was to promote PFMT to prevent UI among antenatal and postnatal women in an obstetric and gynecological hospital in China. A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Six audit criteria that represent best practice recommendations for PFMT were used. A baseline audit was conducted followed by the implementation of multiple strategies and finalized with a follow-up audit to determine change in practice. Results from pre- and post-implementation audits indicated that compliance rates for Criterion 1 (nurse education), Criterion 2 (information providing), Criterion 3 (needs and precautions identifying), Criterion 4 (assessment of pelvic floor function and referral suggestion) reached 100% in the follow-up audit. The compliance rate for Criteria 5 (women education) and Criteria 6 (follow-up providing) attained 90 and 63%, respectively, in the follow-up audit. The project was successful in improving women's knowledge and skills around UI and PFMT. A variety of strategies, such as an effective education program, simple and clear instruments, multiple educational materials can facilitate implementation of evidence in clinical practice. Future plans for continuous improvements in practice and outcomes should be discussed. Further audits will need to be carried out to monitor practice and effect change as required.

Objective To explore the effects of pelvic floor muscle exercises combined with Doula on labor quality and maternal and child health.Methods 292 pregnant women were included in this study.97 of the women began muscle function exercise at a gestational age of 28 weeks until childbirth and received Doula service during labor ( study group ):99 women received conventional prenatal examination and Doula service during labor ( control group 1 ):and another 96 women received tradional delivery care ( control group 2 ).Pelvic muscle tension was compared among the three groups.Duration of labor courses and vaginal delivery status were recorded.Results Muscle tension was stronger in the study group than in the control groups 1 and 2 ( P＜ 0.05 ).Duration of labor courses was shorter,rate of vaginal delivery markedly increased,and rates of C-section,assisted vaginal delivery,fetal distress and suffocation,and postpartum hemorrhage were lower in the study group,with a significant difference.Conclusions Prenatal pelvic floor muscle exercises combined with Doula during delivery can strengthen pelvic muscle tension,restrain adverse mood,shorten labor courses,enhance rate of vaginal delivery,reduce rates of dystocia,newborn suffocation,and postpartum hemorrhage,improve quality of childbirth,and guarantee maternal and child health. Key words: Pelvic floor muscles; Functional exercise; Doula; Delivery quality; Maternal and child health

Objective To analyze the effect of Prolift pelvic floor reconstruction on pelvic organ prolapse and its influence on quality of life (P-QOL) score and pelvic floor muscle strength level. Methods From April 2014 to February 2017, 63 patients with pelvic organ prolapse were selected and randomly divided into two groups. The patients in the control group were treated with traditional vaginal hysterectomy and anterior and posterior vaginal wall repair, while the patients in the observation group were treated with Prolift pelvic floor reconstruction. The clinical effect of two methods after treatment were compared. Results The operative time of the observation group was shorter than that in the control group. The amount of intraoperative bleeding and residual urine after operation in the observation group were lower than those in the control group. The pelvic floor muscle strength level in the observation group was superior to that in the control group. Besides, the quality of life in the observation group was higher than that in the control group one year after operation. The rate of postoperative dysuria and recurrence were lower than that of the control group (P 0.05). Conclusions Prolift pelvic floor reconstruction is a simple, less invasive and safe procedure for the correction of pelvic organ prolapse. It can promote the recovery of pelvic floor muscle function, and the curative effect is better than that of traditional surgery. Key words: Pelvic organ prolapse/SU; Surgical mesh; Postoperative complications; Treatment outcome

The levator ani is thought to play an important role in sexual function; however, to date little literature has been published on the impact of delivery-related levator trauma on female sexual function. We hypothesised that delivery-related levator trauma has a negative impact on women's reports of pelvic floor and sexual function postpartum. In 294 primigravid women with a singleton pregnancy, four-dimensional (4D) translabial ultrasound imaging was used to assess delivery-related levator avulsion and levator hiatal over-distension, and postpartum pelvic floor and sexual function was assessed by an in-house validated questionnaire. Associations between questionnaire responses and levator avulsion and hiatal over-distension were investigated using standard linear modelling methods. Levator avulsion was diagnosed in 14% of women (42 out of 292; 25 unilateral, 17 bilateral) and was found to be significantly associated with lower scores for the pelvic floor integrity and function domain of the questionnaire (P < 0.0005). Avulsion was associated with lower scores for this domain (no avulsion = 2.78, unilateral avulsion = 2.61, bilateral avulsion = 2.29). This association remained significant after controlling for potential confounders (p = 0.013). Avulsion was not associated with any of the other domains of sexual function and levator hiatal over-distension was not associated with scores for any of the questionnaire domains. The effect of levator avulsion on pelvic floor and sexual function an average of 5.2 months after childbirth seems to be limited to a perception of increased vaginal and pelvic floor muscle laxity, and reduced pelvic floor muscle efficiency. The impact of levator hiatal over-distension on postpartum pelvic floor and sexual function appears to be negligible.

Objective To study the clinical effects of postpartum women with vaginal prolapse and bacterial vaginal disease on biofeedback combined with electrical stimulation used in pelvic muscle recover therapy,and explore the effectiveness of the treatment and the positive role, reduce the incidence of pelvic floor functional disease. Methods 157 cases of postpartum women who had detected pelvic floor Ⅰ,Ⅱ muscle fiber strength and vaginal dynamic pressure were selected for the study in our hospital,and divided into the treatment group （82 cases） and the control group group（75 cases）.The treatment group were observed on the basis of biofeedback combined with electri-cal stimulation therapy（ use of phenix USB4 treatment） .The control group were observed on the basis of Kegel exer-cise.Two groups had treatment of bacterial vaginal disease.Results The treatment group after treatment,total effec-tive rate was 93.90%,better than that of the control group.At the same time Aa point,Ap point and POP-Q was bet-ter,Vaginal prolapse was improved,pelvic floorⅠ,Ⅱmuscle fiber strength and vaginal dynamic pressure was signifi-cantly different compared the control group （χ^2 =11.19,P〈0.05） .Conclusion The pelvic floor rehabilitation ther-apy can improve the pelvic floor muscle strength of postpartum women,and improve the symptoms of pelvic organ pro-lapse.There was no pain and no damage.The treatment effect is not affected by vaginitis,and which is worthy of clini-cal application. Key words: Vaginal prolapse ; Electrical stimulation; Biofeedback; Bacterial vaginal disease

Objective To explore the rehabilitation effect of pelvic floor muscle training combined with traditional Chinese medicine in the treatment of mild-moderate pelvic organ prolapse. Methods A prospective case-control study, choosing 103 patients of mild-moderate pelvic organ prolapse from October 2012 to May 2014 in Maternal and Child Health Hospital Outpatient of Hunan Province, which were randomly divided into study group (52 cases ) and control group (51 cases ). All of the patients underwent two courses of pelvic floor muscle training, including Kegel exercise, biofeedback, electrical stimulation therapy, the study group combined with traditional Chinese medicine (Buzhongyiqitang ) at the same time. The efficacy was analyzed before and after treatment of pelvic floor muscle strength, myoelectric potential and indexing of pelvic organ prolapse quantification (POP-Q) changes. Results There weren't statistically significant differences in type I and Ⅱ muscle fiber muscle strength and myoelectric potential of two groups before treatment, while the shrinkage index improved significantly after treatment, and the study group was significantly higher with statistically significant difference (P<0.05). The effective rates of POP-Q indexing changes in two groups were 71.2% and 56.9%, respectively. The effective rate of the study group was significantly higher than the control group(P<0.05). Conclusions The clinical efficacy of pelvic floor muscle training combined with Buzhongyiqitang in the treatment of mild-moderate pelvic organ prolapse was significant, and it had a good clinical value. Key words: Uterine prolapse/TH; BUZHONG YIQI DECOCTION/TU; Exercise; Biofeedback(Psychology); Electric stimulation

Background: Urinary incontinence (UI) in women increases with increasing age and negatively affects quality of life. Pelvic floor exercise is one of a method for UI prevention and intervention as well as improve quality of life. However, study of effects of pelvic floor exercises on the quality of life in community-based incontinent women is limited. Objective: To examine the effects of pelvic floor exercise (PFx) on the quality of life in incontinent women living in a community. Materials and methods: Researchers and village health workers surveyed urinary incontinence conditions of women aged 30-60 years old. Subjects were divided into 2 groups; a pelvic floor exercise group and a control group without exercise. Fifty subjects (mean age 52.31±7.0 years) were recruited from Tonpao community, Sankhampheang, Chiang Mai. They were voluntarily assigned into each group of 25 members. Both groups were comparable in terms of stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI). Pre- and post-tests using the King’s Health Questionnaire-Thai version (KHQ-Thai) and an assessment of urinary incontinence at squat, cough, sneeze, laugh, jump, lift a large object from floor, and hearing running water were administered in both groups. PFx consisted of slow and fast contraction of pelvic floor muscles 30 times a day, 4 days per week for 8 weeks. Frequency of PFx and UI were administered by subject-reported diary. Results: The results showed that PFx group had higher scores on every domain of KHQ-Thai ( p <0.05) compared to pre-PFx; i.e., general health perception, impact of incontinence, role limitation, physical limitations, social limitation, personal relation, emotion, sleep, and severity perception of urinary incontinence. In addition, scores of the severity of UI and quality of life of PFx group was significantly better than control ( p <0.05) except impact of incontinence, social limitation, personal relation and emotion. There were number of subjects in PFx group showing less UI symptoms except in squat and lifting position but there was no significant difference between groups. Conclusion: Women who performed pelvic floor exercise for 8 weeks had fewer occurrences of UI and a better quality of life than those who did not exercise. Therefore, women with UI should be encouraged to do pelvic floor exercises regularly to prevent or reduce incontinence and enhance their quality of life.

Different maternal positions and movement are utilized gradually in clinic while today it appears that the majority of women in the world birth in supine position or lithotomy position. To know the current situation and progress of the studies concerning different maternal positions and movement during labour and to explore the current relevant problems in clinic. The search strategy was designed to identify the relevant literature. The search was limited to the last 20 years as current literature was sought. Thirty eight papers were identified as relevant and included in this literature review. The majority studies is concerning about the outcome of mother and fetus. There is no unitized clinical pathway currently, and the objects implemented are limited. There is no study related to the requirement of implementing different maternal positions and movement during labor in clinic and the effect of pelvic floor function after parturition. The positive effect of implementing different maternal positions and movement during labor can be sure for the process of parturition and the outcome of mother and baby. Childbirth in different maternal positions and movement is the trend in the future. Therefore, how to utilize different maternal positions and movement during labor well, it is still a huge challenge for medical staff. And more convincing studies and information are needed as evidence in clinic. Key words: Parturition; Different maternal positions; Current situation; Progress