Abstract
Abstract
Purpose
The aim of the study was to investigate the association between the initial grade of obstetrical anal sphincter injury (OASIS), and Wexner score parameters, with ultrasonographic findings by endoanal ultrasound (EAUS, golden standard) and transperineal ultrasound (TPUS) 6 months post-partum.
Methods
Fifty-nine women after primary repair of OASIS were included at Helsingborg Hospital, Sweden, 2016–2017. Six months post-partum the women filled in a questionnaire regarding symptoms of anal incontinence by the Wexner score and were scanned with EAUS and TPUS (resting state and contracting state) for classification of the residual defect by a modified Starck score.
Results
Correlations were found between the OASIS grade and residual defects; length (rs = 0.41, P = 0.003), depth (rs = 0.38, P = 0.006) and angle (rs = 0.40, P = 0.004) of the external anal sphincter (EAS) measured with TPUS in resting state. Using EAUS, correlation between OASIS grade and EAS depth (rs = 0.35, P = 0.007) and angle (rs = 0.37, P = 0.004) were similar, but there was no correlation with length (rs = 0.20, P = 0.14). Between incontinence to gas and the angle of the residual defect in the IAS using TPUS in resting state, correlation was moderate (rs = 0.42, P = 0.003). Regarding incontinence to liquid stool, measurements by TPUS in resting state of EAS residual defect depth (rs = 0.46, P < 0.001) and angle (rs = 0.44, P = 0.001) also correlated moderately. Both corresponding correlations using EAUS were weaker.
Conclusion
Defects measured with EAUS and TPUS six months post-partum correlated to initial OASIS grade and symptoms of anal incontinence. Specific symptoms correlated with specific anatomical defects, and TPUS was not an inferior method to EAUS.
Publisher
Springer Science and Business Media LLC
Subject
Radiology Nuclear Medicine and imaging,General Medicine,Internal Medicine
Reference17 articles.
1. Woo VG, Hung YY, Chen HC, Ritterman Weintraub ML (2018) Risk factors for the development of obstetric anal sphincter injuries in modern obstetric practice. Obstet Gynecol 131:290–296
2. Meister MR, Cahill AG, Conner SN, Woolfolk CL, Lowder JL (2016) Predicting obstetric anal sphincter injuries in a modern obstetric population. Am J Obstet Gynecol 215(310):e1–7
3. Guzmán Rojas RA, Shek KL, Langer SM, Dietz HP (2013) Prevalence of anal sphincter injury in primiparous women. Ultrasound Obstet Gynecol 42(4):461–466
4. Valsky DV, Malkiel A, Savchev S, Messing B, Hochner- Celnikier D, Yagel S (2007) 3D transperineal ultrasound follow-up of intrapartum anal sphincter tears and functional correlation with clinical complaints. Ultrasound Obstet Gynecol 30:449
5. Fenner DE, Genberg B, Brahma P, Marek L, DeLancey JOL (2003) Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol 189:1543–1549
Cited by
11 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献