Objective To investigate the clin. diagnostic value of transperineal pelvic floor ultrasound combined with serum soluble microfiber associated protein 4 (sMFAP4) and latent transforming growth factor beta binding protein 2 (LTBP-2) for postpartum pelvic floor dysfunction (PFD).Methods From Oct. 2020 to June 2023, 107 PFD patients diagnosed in the Fourth Hospital of Cangzhou were regarded as the PFD group, including 48 cases with urinary incontinence, 25 cases with pelvic organ prolapse, 10 cases with chronic pelvic pain, 15 cases with intestinal dysfunction and 9 cases with sexual dysfunction.Another 103 healthy volunteers with no PFD after postpartum examination in the Fourth Hospital of Cangzhou during the same period were selected as the control group.Color Doppler ultrasound was used to detect the perineal pelvic floor of the two groups, and the hiatus area of levator ani muscle, the posterior angle of the bladder urethra, the mobility of the bladder neck and the rotation angle of the urethra were measured.The levels of serum sMFAP4 and LTBP-2 were determined by magnetic separation homogeneous enzyme-linked immunoquant. assay technique and ELISA, resp.Receiver operating characteristic (ROC) curve was drawn to analyze the clin. diagnostic value of ultrasound parameters and serum sMFAP4 and LTBP-2 in postpartum PFD.Results Compared with the control group, the hiatus area of levator ani muscle, posterior angle of bladder urethra, bladder neck mobility and urethral rotation angle in the PFD group were obviously increased (P<0.05), while serum levels of sMFAP4 and LTBP-2 were obviously reduced (P<0.05).There was no statistically obvious differences in serum sMFAP4 and LTBP-2 levels among patients with urinary incontinence, pelvic organ prolapse, chronic pelvic pain, intestinal dysfunction and sexual dysfunction (P>0.05).The areas under the curve (AUC) for the diagnosis of postpartum PFD of the hiatus area of levator ani muscle, posterior vesicourethral angle, bladder neck mobility, urethral rotation angle, serum sMFAP4 and LTBP-2 alone and in combination were 0.764 (95%CI: 0.701-0.828), 0.802 (95%CI: 0.743-0.861), 0.764 (95%CI: 0.699-0.828), 0.830 (95%CI: 0.776-0.884), 0.799 (95%CI: 0.738-0.859), 0.773 (95%CI: 0.707-0.838), 0.978 (95%CI: 0.962-0.994), resp., and the AUC of the above six indexes in the combined diagnosis of postpartum PFD was better than that of hiatus area of levator ani muscle, posterior vesicourethral angle, bladder neck mobility, urethral rotation angle, serum sMFAP4 and serum LTBP-2 alone (Z=6.488, 5.669, 6.302, 5.256, 5.591, 6.037, all P<0.001).Conclusion Serum sMFAP4 and LTBP-2 are both low expressed in patients with postpartum PFD, transperineal pelvic floor ultrasound combined with serum sMFAP4 and LTBP-2 has a certain diagnostic value for postpartum PFD, and the value of combined diagnosis of postpartum PFD is higher.