Feasibility of transperineal ultrasound in the delivery room for the management of obstetric anal sphincter injuries: a randomized controlled trial.
Stéphanie Huberlant, Eve Mousty, Jean-François Bourgaux et al.
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In 30 seconds
This randomized controlled trial evaluated the feasibility of transperineal ultrasound (TPUS) for diagnosing obstetric anal sphincter injuries (OASI) in 110 primiparous women post-vaginal delivery. The study found that TPUS identified 7.8% of occult OASIs missed by clinical examination alone. Although the rate of anal incontinence at 5 months postpartum was lower in the TPUS group (2.1%) compared to the clinical examination group (7.8%), the difference was not statistically significant.
Key findings
- TPUS identified 7.8% of occult OASIs in patients diagnosed with second-degree tears.
- The rate of anal incontinence at 5 months was 2.1% in the TPUS group versus 7.8% in the CE group.
- Patient tolerance for TPUS was good, with a mean VAS score of 0.43.
- Inter-observer agreement for TPUS findings was poor, with κ values of 0.259 and 0.367.
Why it matters
The study highlights the potential of TPUS to improve the detection of OASI during delivery, which may influence long-term outcomes such as anal incontinence. Understanding the feasibility and limitations of this technique can guide clinical practice in obstetrics.