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Authordc.contributor.authorGuzmán Rojas, Rodrigo 
Authordc.contributor.authorSalvesen, K. A. 
Authordc.contributor.authorVolloyhaug, I. 
Admission datedc.date.accessioned2018-09-25T14:47:23Z
Available datedc.date.available2018-09-25T14:47:23Z
Publication datedc.date.issued2018-05
Cita de ítemdc.identifier.citationUltrasound Obstet Gynecol 2018; 51: 677–683es_ES
Identifierdc.identifier.other10.1002/uog.18827
Identifierdc.identifier.urihttps://repositorio.uchile.cl/handle/2250/151725
Abstractdc.description.abstractObjectives To establish the prevalence of external (EAS) and internal (IAS) anal sphincter defects present 15-24years after childbirth according to mode of delivery, and their association with development of fecal incontinence (FI). The study additionally aimed to compare the proportion of women with obstetric anal sphincter injuries (OASIS) reported at delivery with the proportion of women with sphincter defect detected on ultrasound 15-24years later. Methods This was a cross-sectional study including 563 women who delivered their first child between 1990 and 1997. Women responded to a validated questionnaire (Pelvic Floor Distress Inventory) in 2013-2014, from which the proportion of women with FI was recorded. Information about OASIS was obtained from the National Birth Registry. Study participants underwent four-dimensional transperineal ultrasound examination. Defect of EAS or IAS of >= 30 degrees in at least four of six slices on tomographic ultrasound was considered a significant defect and was recorded. Four study groups were defined based on mode of delivery of the first child. Women who had delivered only by Cesarean section (CS) constituted the CS group. Women in the normal vaginal delivery (NVD) group had NVD of their first child and subsequent deliveries could be NVD or CS. The forceps delivery (FD) group included women who had FD, NVD or CS after FD of their first born. The vacuum delivery (VD) group included women who had VD, NVD or CS after VD of their first born. Multiple logistic regression was used to calculate adjusted odds ratios (aORs) for comparison of prevalence of an EAS defect following different modes of delivery and to test its association with FI. Fisher's exact test was used to calculate crude odds ratios (ORs) for IAS defects. Results Defects of EAS and IAS were found after NVD (n = 201) in 10% and 1% of cases, respectively, after FD (n = 144) in 32% and 7% of cases and after VD (n=120) in 15% and 4% of cases. No defects were found after CS (n = 98). FD was associated with increased risk of EAS defect compared with NVD (aOR = 3.6; 95% CI, 2.0-6.6) and VD (aOR = 3.0; 95% CI, 1.6-5.6) and with increased risk of IAS defect compared with NVD (OR=7.4; 95% CI, 1.5-70.5). The difference between VD and NVD was not significant for EAS or IAS. FI was reported in 18% of women with an EAS defect, in 29% with an IAS defect and in 8% without a sphincter defect. EAS and IAS defects were associated with increased risk of FI (aOR = 2.5 (95% CI, 1.3-4.9) and OR = 4.2 (95% CI, 1.1-13.5), respectively). Of the ultrasonographic sphincter defects, 80% were not reported as OASIS at first or subsequent deliveries. Conclusions Anal sphincter defects visualized on transperineal ultrasound 15-24years after first delivery were associated with FD and development of FI. Ultrasound revealed a high proportion of sphincter defects that were not recorded as OASIS at delivery. Copyright (C) 2017 ISUOG. Published by John Wiley & Sons Ltd.es_ES
Lenguagedc.language.isoenes_ES
Publisherdc.publisherWileyes_ES
Type of licensedc.rightsAttribution-NonCommercial-NoDerivs 3.0 Chile*
Link to Licensedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/*
Sourcedc.sourceUltrasound in Obstetrics & Gynecologyes_ES
Keywordsdc.subjectAnal sphincter defectes_ES
Keywordsdc.subjectFecal incontinencees_ES
Keywordsdc.subjectForceps deliveryes_ES
Keywordsdc.subjectObstetric anal sphincter injuryes_ES
Keywordsdc.subjectTransperineal ultrasoundes_ES
Keywordsdc.subjectVacuum deliveryes_ES
Títulodc.titleAnal sphincter defects and fecal incontinence 15–24 years after first delivery: a cross-sectional studyes_ES
Document typedc.typeArtículo de revista
Catalogueruchile.catalogadorrgfes_ES
Indexationuchile.indexArtículo de publicación ISIes_ES
Indexationuchile.indexArtículo de publicación SCOPUSes_ES


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Attribution-NonCommercial-NoDerivs 3.0 Chile
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivs 3.0 Chile