干旱区生态环境知识资源中心(Arid): Under-classified obstetric anal sphincter injuries

Arid

DOI	10.1007/s00192-021-05051-y
	Under-classified obstetric anal sphincter injuries
	Roper, Joanna C.; Thakar, Ranee; Sultan, Abdul H.
通讯作者	Sultan, AH (corresponding author)，Croydon Univ Hosp, Dept Obstet & Gynaecol, London Rd, Croydon CR7 7YE, England. ; Sultan, AH (corresponding author)，St Georges Univ London, London, England.
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2022-02
英文摘要	Introduction and hyposthesis Obstetric anal sphincter injuries (OASIs) that are missed at delivery can have long-term consequences. OASIs that are under-classified at delivery are likely to be inadequately repaired, resulting in a persistent anal sphincter defect. We aimed to identify women who have persistent defects on endoanal ultrasound, inconsistent with the original diagnosis, and compare the effect on St Mark's incontinence scores (SMIS). We also aimed to look for changes in numbers of under-classification over time. Methods Records of women attending a perineal clinic who had endoanal ultrasound from 2012 to 2020 were reviewed. Women who had a modified Starck score implying a defect greater than the classification [indicated by the depth of external anal sphincter or internal anal sphincter (IAS) defect] at delivery were identified. Results A total of 1056 women with a diagnosis of 3a or 3b tears were included. Of these, 120 (11.36%) were found to have a defect greater than the original diagnosis and therefore were incorrectly classified at delivery. Women who had a 3b tear diagnosed at delivery, but had an IAS defect, had a significantly higher SMIS (p < 0.01). When comparing two 4-year periods, there was a significant improvement in the diagnosis of IAS tears. Conclusion Some women with OASIs that have under-classified OASIs are associated with worse anorectal symptoms. This is likely because of an incomplete repair. Some improvement in diagnosis of IAS tears has been noted. We propose improved training in OASIs can help reduce the number of incorrectly classified tears and improve repair.
英文关键词	Obstetric anal sphincter injuries Diagnosis of third-degree tears St Mark's incontinence score Starck score Endoanal ultrasound
类型	Article ; Early Access
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000754365800001
WOS关键词	FECAL INCONTINENCE ; DIAGNOSIS ; DELIVERY ; REPAIR ; TEARS ; OASIS ; TIME
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/377299
作者单位	[Roper, Joanna C.; Thakar, Ranee; Sultan, Abdul H.] Croydon Univ Hosp, Dept Obstet & Gynaecol, London Rd, Croydon CR7 7YE, England; [Thakar, Ranee; Sultan, Abdul H.] St Georges Univ London, London, England
推荐引用方式 GB/T 7714	Roper, Joanna C.,Thakar, Ranee,Sultan, Abdul H.. Under-classified obstetric anal sphincter injuries[J],2022.
APA	Roper, Joanna C.,Thakar, Ranee,&Sultan, Abdul H..(2022).Under-classified obstetric anal sphincter injuries.INTERNATIONAL UROGYNECOLOGY JOURNAL.
MLA	Roper, Joanna C.,et al."Under-classified obstetric anal sphincter injuries".INTERNATIONAL UROGYNECOLOGY JOURNAL (2022).