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Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are a common cause of maternal morbidity with an overall incidence in the UK of 2.9% (range 0–8%). They can cause a range of physical symptoms and psychological distress. This study aims to assess the accuracy of clinical diagnos...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569308/ https://www.ncbi.nlm.nih.gov/pubmed/34971421 http://dx.doi.org/10.1007/s00192-021-05044-x |
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author | Jones, Angharad Ferrari, Linda Martinez, Paula Igualada Oteng-Ntim, Eugene Hainsworth, Alison Schizas, Alexis |
author_facet | Jones, Angharad Ferrari, Linda Martinez, Paula Igualada Oteng-Ntim, Eugene Hainsworth, Alison Schizas, Alexis |
author_sort | Jones, Angharad |
collection | PubMed |
description | INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are a common cause of maternal morbidity with an overall incidence in the UK of 2.9% (range 0–8%). They can cause a range of physical symptoms and psychological distress. This study aims to assess the accuracy of clinical diagnosis of OASIS using endoanal ultrasound (EAUS) and the correlation between confirmed injury and change to anorectal physiology squeeze pressure and the incidence of bowel symptoms. METHODS AND MATERIALS: Retrospective study of prospectively collected data from 1135 women who attended the Third- and Fourth-Degree Tears Clinic at our institution, 12 weeks post-delivery, between June 2008 and October 2019. RESULTS: OASIS was confirmed in 876 (78.8%) women and 236 (21.3%) had no injury. Of the women who underwent anorectal physiology, 45.6% had a mean maximal resting pressure below the normal range and 68.8% had a mean incremental squeeze pressure below normal. Women with confirmed OASIS had significantly lower pressures (p < 0.001) than those without a confirmed sphincter injury. Three hundred ninety-three (34.8%) women reported bowel symptoms, with those with endosonographic evidence of injury more likely to develop flatus incontinence. CONCLUSION: Of the women in this study with a suspected OASIS, 21.2% could be reassured that they did not have an injury. This information is useful for women considering future mode of delivery. Those with confirmed injury are more likely to complain of flatus incontinence and have reduced anal sphincter pressures. |
format | Online Article Text |
id | pubmed-9569308 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-95693082022-10-17 Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury Jones, Angharad Ferrari, Linda Martinez, Paula Igualada Oteng-Ntim, Eugene Hainsworth, Alison Schizas, Alexis Int Urogynecol J Original Article INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are a common cause of maternal morbidity with an overall incidence in the UK of 2.9% (range 0–8%). They can cause a range of physical symptoms and psychological distress. This study aims to assess the accuracy of clinical diagnosis of OASIS using endoanal ultrasound (EAUS) and the correlation between confirmed injury and change to anorectal physiology squeeze pressure and the incidence of bowel symptoms. METHODS AND MATERIALS: Retrospective study of prospectively collected data from 1135 women who attended the Third- and Fourth-Degree Tears Clinic at our institution, 12 weeks post-delivery, between June 2008 and October 2019. RESULTS: OASIS was confirmed in 876 (78.8%) women and 236 (21.3%) had no injury. Of the women who underwent anorectal physiology, 45.6% had a mean maximal resting pressure below the normal range and 68.8% had a mean incremental squeeze pressure below normal. Women with confirmed OASIS had significantly lower pressures (p < 0.001) than those without a confirmed sphincter injury. Three hundred ninety-three (34.8%) women reported bowel symptoms, with those with endosonographic evidence of injury more likely to develop flatus incontinence. CONCLUSION: Of the women in this study with a suspected OASIS, 21.2% could be reassured that they did not have an injury. This information is useful for women considering future mode of delivery. Those with confirmed injury are more likely to complain of flatus incontinence and have reduced anal sphincter pressures. Springer International Publishing 2021-12-31 2022 /pmc/articles/PMC9569308/ /pubmed/34971421 http://dx.doi.org/10.1007/s00192-021-05044-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Jones, Angharad Ferrari, Linda Martinez, Paula Igualada Oteng-Ntim, Eugene Hainsworth, Alison Schizas, Alexis Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title | Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title_full | Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title_fullStr | Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title_full_unstemmed | Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title_short | Anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
title_sort | anal endosonographic assessment of the accuracy of clinical diagnosis of obstetric anal sphincter injury |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569308/ https://www.ncbi.nlm.nih.gov/pubmed/34971421 http://dx.doi.org/10.1007/s00192-021-05044-x |
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