Impact of mediolateral episiotomy on incidence of obstetrical anal sphincter injury diagnosed by endoanal ultrasound

Starič, Kristina Drusany; Lukanović, Adolf; Petročnik, Petra; Začesta, Vita; Cescon, Corrado; Lučovnik, Miha

doi:10.1016/j.midw.2017.05.008

Cited by 13 publications

(15 citation statements)

References 26 publications

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“…61,83,122,125,141,142, 146,170,183,199,200,227,251,253,258,261,264,285,296,298,302,353 Endoanal ultrasonography was performed in 104 studies (34.0%). 53,65,72,73,76–78,80,83,86,90,92,104,105,109,110,113, 115,122,125,127,133,141,142,146,151–153,155,157,162,163,165,167,172–176,178,179,183,191,193,…”

Section: Resultsmentioning

confidence: 99%

“…After careful evaluation of full‐text papers 27 studies were excluded: 15 studies 23–37 did not evaluate FI assessment, six manuscripts 38–43 were just protocols, five were paediatric studies, 44–48 and one trial 49 had an inappropriate study design. Finally, 328 studies were included in our review: 306 studies…”

Section: Resultsmentioning

confidence: 99%

“…FI was assessed using specific questionnaires in all studies, except for four trials 168 , 213 , 274 , 280 . Twenty‐nine different questionnaires were applied: the most widely adopted were the Wexner score (187 studies), 50 , 52 , 54 , 55 , 59 , 61 , 63 , 66 , 69–71 , 73–83 , 86–92 , 97–99 , 101 , 103–107 , 110 , 114 , 116 , 117 , 120–123 , 126–128 , 130 , 131 , 133 , 135–139 , 141 , 144 , 146–156 , 160 , 164–167 , 169 , 170 , 174 , 177–179 , 182 , 194–203 , 205–208 , 210–212 , 214 , 215 ,…”

Section: Resultsmentioning

confidence: 99%

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Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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“…20 In an endoanal ultrasound study with 60 participants which evaluates impact of mediolateral episiotomy on incidence of obstetrical anal sphincter injury, authors suggested that mediolateral episiotomy does not seem to be protective against clinical or sonographic diagnosed OASIS even when episiotomy technique is considered. 21 In studies comparing mediolateral episiotomy with medial episiotomy, it is clear that mediolateral episiotomy has a lower risk of obstetric injury compared to median episiotomy. 20,22 If an episiotomy is required, mediolateral episiotomy has been shown to be a protective intervention for OASI, especially in nulliparous women.…”

Section: Discussionmentioning

confidence: 99%

Risk of Obstetric Anal Sphincter Injury with Fundal Pressure in Second Stage of Labour; Transperineal Ultrasound Study

ONCU¹,

Aydın²,

Aydın³

2020

Preprint

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Objective: The aim of this study was to evaluate the effect of using uterine fundal pressure during the second stage of delivery on obstetric anal sphincter injury (OASI), among primiparous women using three-dimensional transperineal ultrasonography. Design: Case control study Setting: Tertiary Urogynecology Unit Population: Nulliparous women with term, singleton, cephalic presentation gestation delivered with fundal pressure in second stage of labour. Main Outcome Measure: Complete, incomplete IAS and EAS defect in transperineal tomographic ultrasound imaging Method: A total of 73 women who had their first vaginal birth were included in the study, 37 of them applied fundal pressure and 36 of them delivered spontaneously without fundal pressure. Tomographic ultrasound imaging with 3D transperineal assessment was performed within 48 h of delivery, IAS and EAS defect were determined. Results: Five (13.5%) women in the fundal pressure group, 7 (20%) women in the control group had complete EAS (p = 0.4). Complete IAS was observed in 1 (2.7%) women in the fundal pressure group and 2 (5.7%) women in the control group (p = 0.5). Half-moon sign was observed in 1 woman in both groups (p = 0.9). The rate of other signs were similar in both groups. Multivariate regression models revealed that none of, age, episiotomy, length of second stage of labour, fundal pressure application status and number were independent predictor of complete IAS or EAS defect. Conclusions: Fundal pressure during the second stage of delivery is not cause increase in rate of OASI detected with ultrasonography.

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“…However, other studies have shown that episiotomy and 3rd or 4th degree perineal lacerations increase the risk of anal incontinence after vaginal birth by 1.7 and 2.7 times, respectively . A recent study suggested that mediolateral episiotomy is not protective of the occurrence of OASIS, but the sample size was small, and therefore the study was not powered to provide substantial clinical conclusions …”

mentioning

confidence: 95%

FIGO Statement: Restrictive use rather than routine use of episiotomy

Nassar

Visser

Ayres‐de‐Campos³

et al. 2019

Intl J Gynecology & Obste

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Impact of mediolateral episiotomy on incidence of obstetrical anal sphincter injury diagnosed by endoanal ultrasound

Cited by 13 publications

References 26 publications

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Risk of Obstetric Anal Sphincter Injury with Fundal Pressure in Second Stage of Labour; Transperineal Ultrasound Study

FIGO Statement: Restrictive use rather than routine use of episiotomy

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