文摘
The most common cause of anal sphincter injuries in women is vaginal birth. Endo-anal ultrasound is currently used for the diagnosis of anal sphincter defect. However, due to the inconvenience caused, it is not an applicable technique during the immediate postpartum.The aim of this study was to determine whether transperineal ultrasound in 3/4D is a useful diagnostic method for the assessment of anal sphincter during the immediate postpartum.Material and methodsA prospective study was conducted on the vaginal deliveries performed between September 2012 and June 2013 in the Valme University Hospital (Seville). Obstetric and foetal parameters that could influence the onset of perineal tears were studied. The patients underwent a transperineal 3/4D ultrasound and a multislice study (48 h after birth).ResultsThe study included 146 puerperal women. The sphincter complex was assessed in all of them during the immediate postpartum. External anal injuries were observed in 10.3% of the cases. In 8.2% of cases, the primary suture of the external anal sphincter was detected during ultrasound examination, and 2.1% of asymptomatic lesions were diagnosed only with postpartum ultrasound. None of the patients reported discomfort or pain.ConclusionsThe 3-dimensional transperineal ultrasound is helpful in determining the primary repair of the anal sphincter during the immediate postpartum, with no discomfort for patients, as well as for establishing those early sphincter injuries that go unnoticed during vaginal delivery.
