干旱区生态环境知识资源中心(Arid): Is there a role for transperineal ultrasound imaging of the anal sphincter immediately after primary repair of third degree tears?

Arid

DOI	10.1016/j.ejogrb.2022.02.182
	Is there a role for transperineal ultrasound imaging of the anal sphincter immediately after primary repair of third degree tears?
	Wong, Ka Woon; Thakar, Ranee; Andrews, Vasanth; Sultan, Abdul H.
通讯作者	Sultan, AH
来源期刊	EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
ISSN	0301-2115
EISSN	1872-7654
出版年	2022
卷号	271 页码:260-264
英文摘要	Objective: When obstetric anal sphincter injuries are identified, it is crucial that the defects are repaired appropriately to achieve a better outcome. Although the presence of an intact anal sphincter is not the sole mechanism for maintaining continence, and not all women with an anal sphincter defect are symptomatic, there is an association between sphincter defects and anal incontinence. Our aim was to evaluate whether transperineal ultrasound (TPUS) is useful in assessing anal sphincter integrity immediately following primary repair of obstetric anal sphincter injuries (OASIs). Study Design: This is a prospective observational study of women who sustained OASIs during their first vaginal delivery. Three dimensional (3D) TPUS was performed immediately after repair of OASIs to identify anal sphincter defects. A repeat TPUS was performed 12 weeks following repair. Results: 21 women sustained OASIs of whom 20 (95%) attended follow up. Eight (40%) had a grade 3a tear and 12 (60%) a 3b tear. 8/20 (40%) women had residual external anal sphincter (EAS) defects identified by TPUS immediately after repair. Of these eight defects, six (75%) persisted at 12 weeks postpartum. No new defects were seen at follow up among the twelve women in whom no defect was seen immediately following the repair. Six residual EAS defects were found at 12 weeks postpartum. An EAS defect at 12 weeks postpartum was associated with anal incontinence (p = 0.04). Women with 3b tears were more likely to have anal incontinence (AI) and residual sonographic EAS defects when compared with 3a tears but this was not statistically significant. Conclusions: Women who had no TPUS defect detected immediately following primary repair of OASIs, remained as such at 12 weeks postpartum. Of those in whom a defect was seen immediately after repair, it persisted in 75% of cases at 12 weeks. We believe that the value of TPUS immediately after repair appears to be limited and would need to be defined if it were to be considered for routine practice. Further research on its role immediately after repair of major tears (Grade 3C/4) is needed. In addition, performing ultrasound would require widespread training of obstetricians to develop expertise. This highlights the importance of adequate training of obstetricians in OASI repair.
英文关键词	Transperineal ultrasound Anal incontinence Obstetric anal sphincter injuries Third-degree tears Childbirth
类型	Article
语种	英语
开放获取类型	Green Accepted
收录类别	SCI-E
WOS记录号	WOS:000792965300016
WOS关键词	INJURIES OASIS ; INCONTINENCE ; DEFECTS ; ENDOSONOGRAPHY ; MANAGEMENT
WOS类目	Obstetrics & Gynecology ; Reproductive Biology
WOS研究方向	Obstetrics & Gynecology ; Reproductive Biology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/392558
推荐引用方式 GB/T 7714	Wong, Ka Woon,Thakar, Ranee,Andrews, Vasanth,et al. Is there a role for transperineal ultrasound imaging of the anal sphincter immediately after primary repair of third degree tears?[J],2022,271:260-264.
APA	Wong, Ka Woon,Thakar, Ranee,Andrews, Vasanth,&Sultan, Abdul H..(2022).Is there a role for transperineal ultrasound imaging of the anal sphincter immediately after primary repair of third degree tears?.EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY,271,260-264.
MLA	Wong, Ka Woon,et al."Is there a role for transperineal ultrasound imaging of the anal sphincter immediately after primary repair of third degree tears?".EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 271(2022):260-264.