NCT03039582

Short Anovaginal Distance is Associated With Obstetric Anal Sphincter Rupture

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 151 (actual)
• Sponsor: Ostergotland County Council, Sweden · Academic / Other
• Sex: Female
• Age: —
• Healthy volunteers: Not accepted

Summary

Anovaginal distance measured by palpation and perineal ultrasound are similar.

Detailed description

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.

Conditions

• Perineal Tear
• Obstetric Trauma

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	Bidigital palpation	palpation of the anovaginal distance with two fingers
DIAGNOSTIC_TEST	Perineal ultrasound	ultrasound measurement of the anovaginal distance

Timeline

• Start date: 2014-09-01
• Primary completion: 2016-01-31
• Completion: 2017-01-19
• First posted: 2017-02-01
• Last updated: 2017-02-13