Arid
DOI10.1111/aogs.14515
Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study
Okeahialam, Nicola Adanna; Thakar, Ranee; Sultan, Abdul H.
通讯作者Sultan, AH
来源期刊ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
ISSN0001-6349
EISSN1600-0412
出版年2023
卷号102期号:4页码:473-479
英文摘要Introduction: Perineal wound infection can affect tissues at superficial, deep, and organ space levels. Women with obstetric anal sphincter injuries (OASIS) are at risk of infection; however, no study to date has investigated if infection can extend to affect the anal sphincter integrity. The aim of this study was to evaluate the clinical progression of perineal wound infection and its effect on the anal sphincter in women with or without OASIS using three-dimensional endoanal ultrasound (3D-EAUS). Material and methods: Women were recruited into the Prospective Observational Study Evaluating the Sonographic Appearance of the Anal Sphincter in Women With Perineal Wound Infection Following Vaginal Delivery (PERINEAL Study) between August 2020 and August 2021 (NCT 04480684). 3D-EAUS was performed weekly until complete wound healing. Significant bacterial colonization was diagnosed using the MolecuLight i:X camera. The primary study outcome was a change in a sphincter defect angle from baseline (wound infection) until wound healing. A robust Poisson regression model was used to analyze the effect of significant bacterial loads on the anal sphincter. Results: Seventy-three women were included. A median of two ultrasound scans were performed in each patient (range 1-16). Five women (6.8%) had an OASI clinically diagnosed at delivery. In total, 250 EAUS were performed. An external anal sphincter defect was found on EAUS in 55 (22.0%) scans (n = 10 women). An external anal sphincter and internal anal sphincter defect was found in 26 scans (10.4%) (n = 3 women). During the course of the wound healing process, there was no significant change in defect size in wounds with or without significant bacterial colonization. In cases of an intact anal sphincter, wound infection did not disrupt its integrity. Conclusions: We found that perineal wound infection does not disrupt an intact anal sphincter or OASIS. This new information can provide important information for clinicians and patients. As there are myths frequently encountered in cases of litigation when disruption of sphincter integrity is attributed to perineal infection, the findings of this study should be tested in larger studies in the future.
英文关键词bacterial autofluorescence endoanal ultrasound obstetric anal sphincter injury perineal wound infection severe perineal laceration third-degree tears transperineal ultrasound
类型Article
语种英语
开放获取类型Green Published, Green Accepted, hybrid
收录类别SCI-E
WOS记录号WOS:000918934300001
WOS关键词PREDICTS
WOS类目Obstetrics & Gynecology
WOS研究方向Obstetrics & Gynecology
资源类型期刊论文
条目标识符http://119.78.100.177/qdio/handle/2XILL650/394961
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Okeahialam, Nicola Adanna,Thakar, Ranee,Sultan, Abdul H.. Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study[J],2023,102(4):473-479.
APA Okeahialam, Nicola Adanna,Thakar, Ranee,&Sultan, Abdul H..(2023).Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study.ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA,102(4),473-479.
MLA Okeahialam, Nicola Adanna,et al."Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study".ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 102.4(2023):473-479.
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