Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS).

Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS). Ultrasound Obstet Gynecol. 2018 Mar 24;: Authors: Eisenberg VH, Valsky DV, Yagel S Abstract Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult. Having sustained an OASI may impact significantly on women's physical and emotional health. Missed OASI, inadequate repair or lack of follow up are potential sources of litigation4 . The reported incidence of OASI may be as high as 4-6.6%4 , averaging 2.9% in the UK3 . The incidence is higher in primiparae (6.1%) than in multiparae (1.7%) 3 . Recent years are seeing an increased awareness and structured training programs, which appear to have resulted in an increase in the detection rate of OASI3 . The following risk factors have been identified with varying risk rates reported3 : Asian ethnicity (OR 2.27, 95% CI 2.14-2.41), nulliparity (relative risk [RR] 6.97, 95% CI 5.40-8.99), birth weight greate...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research