The clinical significance of postpartum transperineal ultrasound of the anal sphincter

Maslovitz, S., Jaffa, A., Levin, I., Almog, B., Lessing, J.B. and Wolman, I. (2007)

This study considered the clinical significance of postpartum anal sphincter damage by transperineal ultrasonography (TPUS) performed on the day of delivery.

154 consecutive primiparous women were given continence questionnaires and a TPUS was performed 6-24 hours post vaginal delivery.  This was reassessed at 2 months and 6 months following the birth.

The study found that 23% of women complained of anal incontinence on the first postpartum day, and anal sphincter damage was demonstrated by TPUS in 89% of these women.  Four women with anorectal complaints had an intact anal sphincter when assessed by TPUS.

2 months post partum, follow up questionnaires demonstrated 30 women who were symptomatic, all of which had sonographically recognised tears on the initial TPUS, with 27 having positive findings on the 2 month TPUS.  6 months post delivery, 27 women reported symptoms, all of whom had sphincteric disruption on the initial TPUS scan.  All women with an intact sphincter on the initial TPUS were asymptomatic 6 months later.

This demonstrates that TPUS findings on the day of delivery are related to long term anorectal complaints, which supports the role that TPUS could play as a screening aid for anal sphincter tears.

European Journal of Obstetrics & Gynecology and Reproductive Biology
(2007) 134:1, 115-119

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