干旱区生态环境知识资源中心(Arid): The consequences of undiagnosed obstetric anal sphincter injuries (OASIS) following vaginal delivery

Arid

DOI	10.1007/s00192-019-04033-5
	The consequences of undiagnosed obstetric anal sphincter injuries (OASIS) following vaginal delivery
	Taithongchai, Annika; Veiga, Susana I.; Sultan, Abdul H.; Thakar, Ranee
通讯作者	Thakar, R (corresponding author), Croydon Univ Hosp, 530 London Rd, London CR7 7YE, England.
会议名称	Annual Meeting of the British-Society-of-Urogynecology (BSUG), Royal-College-of-Obstetricians-and-Gynaecologists
会议日期	NOV09, 2018
会议地点	London, ENGLAND
英文摘要	Introduction and hypothesis We aimed to compare anal and urinary incontinence symptoms and anal manometry between women with undiagnosed obstetric anal sphincter injuries (OASIS) and women who had OASIS diagnosed and repaired. Methods This was a matched retrospective cohort study. Each missed OASI was matched with a diagnosed OASI for severity [minor (3a/b) or major (3c)], parity and length of follow-up. Women completed the modified St Mark's Incontinence Score and International Consultation on Incontinence Questionnaire. Women with OASIS or those without OASIS but with anal incontinence symptoms were seen in perineal clinic for perineal examinations, anorectal manometry and three-dimensional endoanal ultrasound 8-12 weeks postnatally or in a subsequent pregnancy. Results Forty missed OASIS were matched with 40 recognised OASIS (16 3a/b; 24 3c). The median modified St Mark's scores were higher for missed tears [11 (4, 15) vs. 1 (0, 4), p < 0.001] as well as the urinary incontinence scores [4 (0, 6) vs. 0 (0, 2), p = 0.01] than for the control group. Missed OASIS patients had a shorter perineal body [1.6 +/- 1.3 vs. 2.4 +/- 0.8, p = 0.009]. All missed OASIS had larger defects on endoanal ultrasound. One in four missed OASIS required further surgery [aOR 4.1 (95% CI 1.0-16.3), p = 0.04] and almost all needed colorectal input [aOR 24.1 (95% CI 7.3-80.0), p < 0.0001]. There were no differences in anal manometry. Conclusions Women with symptomatic missed OASIS are compromised in terms of anal and urinary incontinence symptoms, sphincter defect size and perineal body size requiring additional colorectal input. This highlights the importance of preventing OASIS and perseverance with training to diagnose OASIS.
英文关键词	Anal incontinence Missed OASIS Obstetric anal sphincter injuries Third-degree tears Urinary incontinence Anal ultrasound
来源出版物	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2020
卷号	31
期号	3
页码	635-641
出版者	SPRINGER LONDON LTD
类型	Article; Proceedings Paper
语种	英语
国家	England
收录类别	CPCI-S
WOS记录号	WOS:000521333300025
WOS关键词	URINARY-INCONTINENCE ; PRIMARY REPAIR ; 3RD-DEGREE
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
资源类型	会议论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/313862
作者单位	[Taithongchai, Annika; Veiga, Susana I.; Sultan, Abdul H.; Thakar, Ranee] Croydon Univ Hosp, 530 London Rd, London CR7 7YE, England
推荐引用方式 GB/T 7714	Taithongchai, Annika,Veiga, Susana I.,Sultan, Abdul H.,et al. The consequences of undiagnosed obstetric anal sphincter injuries (OASIS) following vaginal delivery[C]:SPRINGER LONDON LTD,2020:635-641.