干旱区生态环境知识资源中心(Arid): Obstetric anal sphincter injuries (OASIS): using transperineal ultrasound (TPUS) for detecting, visualizing and monitoring the healing process

Arid

DOI	10.1186/s12905-022-01915-7
	Obstetric anal sphincter injuries (OASIS): using transperineal ultrasound (TPUS) for detecting, visualizing and monitoring the healing process
	Stickelmann, Anna-Lena; Kennes, Lieven Nils; Holscher, Miriam; Graef, Charlotte; Kupec, Tomas; Wittenborn, Julia; Stickeler, Elmar; Najjari, Laila
通讯作者	Stickelmann, AL
来源期刊	BMC WOMENS HEALTH
EISSN	1472-6874
出版年	2022
卷号	22 期号:1
英文摘要	Purpose The aim of this study was to examine whether OASIS, and its extent, can be confirmed or excluded using transperineal ultrasound (TPUS). A further objective of this study was to monitor the healing process over a period of 6 months and to establish a connection between the sonographic appearance of obstetric anal sphincter injury (OASIS) and anal incontinence. Materials and methods In this retrospective clinical study, women with OASIS who gave birth between March 2014 and August 2019 were enrolled. All the patients underwent TPUS 3 days and 6 months after delivery. A GE E8 Voluson ultrasound system with a 3.5-5 MHz ultrasound probe was used. The ultrasound images showed a third-degree injury, with the measurement of the width of the tear and its extent (superficial, partial, complete, EAS and IAS involvement). A positive contraction effect, a sign of sufficient contraction, was documented. Six months after delivery, a sonographic assessment of the healing (healed, scar or still fully present) was performed. A Wexner score was obtained from each patient. The patients' medical histories, including age, parity, episiotomy and child's weight, were added. Results Thirty-one of the 55 recruited patients were included in the statistical evaluation. Three patients were excluded from the statistical evaluation because OASIS was excluded on TPUS 3 days after delivery. One patient underwent revision surgery for anal incontinence and an inadequately repaired anal sphincter injury, as shown sonographic assessment, 9 days after delivery. Twenty patients were excluded for other reasons. The results suggest that a tear that appears smaller (in mm) after 3 days implies better healing after 6 months. This effect was statistically significant, with a significance level of alpha = 5% (p = 0.0328). Regarding anal incontinence, women who received an episiotomy had fewer anal incontinence symptoms after 6 months. The effect of episiotomy was statistically significant, with a significance level of alpha = 5% (p = 0.0367). Conclusion TPUS is an accessible, non-invasive method for detecting, quantifying, following-up and monitoring OASIS in patients with third-degree perineal tears. The width, as obtained by sonography, is important with regard to the healing of OASIS. A mediolateral episiotomy seems to prevent anal incontinence after 6 months.
英文关键词	Transperineal ultrasound Obstetric anal sphincter injury Third-degree perineal tear Anal sphincter injuries
类型	Article
语种	英语
开放获取类型	Green Published, gold
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000838642500001
WOS关键词	3-DIMENSIONAL ULTRASOUND ; FECAL INCONTINENCE ; TEARS
WOS类目	Public, Environmental & Occupational Health ; Obstetrics & Gynecology
WOS研究方向	Public, Environmental & Occupational Health ; Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/392017
推荐引用方式 GB/T 7714	Stickelmann, Anna-Lena,Kennes, Lieven Nils,Holscher, Miriam,et al. Obstetric anal sphincter injuries (OASIS): using transperineal ultrasound (TPUS) for detecting, visualizing and monitoring the healing process[J],2022,22(1).
APA	Stickelmann, Anna-Lena.,Kennes, Lieven Nils.,Holscher, Miriam.,Graef, Charlotte.,Kupec, Tomas.,...&Najjari, Laila.(2022).Obstetric anal sphincter injuries (OASIS): using transperineal ultrasound (TPUS) for detecting, visualizing and monitoring the healing process.BMC WOMENS HEALTH,22(1).
MLA	Stickelmann, Anna-Lena,et al."Obstetric anal sphincter injuries (OASIS): using transperineal ultrasound (TPUS) for detecting, visualizing and monitoring the healing process".BMC WOMENS HEALTH 22.1(2022).