Short Anovaginal Distance is Associated With Obstetric Anal Sphincter Rupture
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 151
- 主要终点
- Correlation between palpated and ultrasound- measured anovaginal distance
研究概览
简要总结
Anovaginal distance measured by palpation and perineal ultrasound are similar.
详细描述
Background: Objective diagnostic methods for obstetric anal sphincter rupture, (OASR) such as endoanalt ultrasound (EAUS), show missed ruptures that can lead to anal incontinence. To perform EAUS after all deliveries at all hours, although it may lead to diagnostic improvement is not feasible in most delivery wards. Another objective method for screening women after delivery to identify OASR would be of value. Bidigital palpation of the perineum is often suggested without specifying what results are relevant.
AIM:
The aim of this study was to establish if the palpated anovaginal distance after delivery could be confirmed by perineal ultrasound and correlated to the extent of the perineal tear.
MATERIALS AND METHODS
A structured educational programme for midwives (palpation) and doctors (perineal ultrasound) was accomplished. Midwives were instructed to record the palpated anovaginal distance in primiparae with spontaneous vaginal delivery and no episiotomy. If the AVD was found to be shorter than 2 cm, she recorded a primary diagnosis of probable grade 2, suspected grade 3 or probable grade 3 and called the doctor. The AVD was then measured by perineal ultrasound by a doctor aware of a laceration but not it´s extent, which was then established by clinical exam and perineal ultrasound.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Prospective
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •women who just had their firstborn child through vaginal delivery at the delivery ward at the University Hospital in Linköping, Sweden from October 2014 to January
排除标准
- •inability to understand swedish
结局指标
主要结局
Correlation between palpated and ultrasound- measured anovaginal distance
时间窗: immediate
Does palpation give a reliable result?
次要结局
- Anal Sphincter rupture incidence(immediate)
研究者
Eva Uustal
Senior consultant
Ostergotland County Council, Sweden