Revista da Associacao Medica Brasileira
Intrapartum rectovaginal distance as a predictor of obstetric anal sphincter injury: a prospective cohort study
Par Bademci EG, Erdim YŞ, Özsoy EY et 1 autres.
Contenu en anglais
Résumé
Objective
The aim of this study was to evaluate the relationship between intrapartum rectovaginal distance measured by transperineal ultrasonography and obstetric anal sphincter injury severity and second-stage labor duration in nulliparous women undergoing vaginal delivery.
Methods
This prospective cohort study was conducted at a tertiary referral center in Istanbul, between September 2021 and January 2022. Of 200 consecutive nulliparous women with singleton pregnancies at ≥37 weeks' gestation, 148 who underwent vaginal delivery were included in the primary analysis. Intrapartum rectovaginal distance was measured in the midsagittal plane by 2D transperineal ultrasonography using a single operator during the inter-contraction rest period, at a fetal head station ranging from -1 to +1. Angle of progression and levator ani anteroposterior diameter were also recorded. Obstetric injury was graded per American College of Obstetricians and Gynecologists 2016 criteria; grade 3-4 laceration (severe obstetric anal sphincter injury) was the primary outcome.