Short Anovaginal Distance is Associated With Obstetric Anal Sphincter Rupture
NCT ID: NCT03039582
Last Updated: 2017-02-13
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
151 participants
OBSERVATIONAL
2014-09-01
2017-01-19
Brief Summary
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Detailed Description
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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
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Study Design
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CASE_ONLY
PROSPECTIVE
Study Groups
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Probable grad 2
Perineal laceration Probable grad 2
Bidigital palpation
palpation of the anovaginal distance with two fingers
Perineal ultrasound
ultrasound measurement of the anovaginal distance
Suspected grade 3
Perineal laceration Suspected grade 3
Bidigital palpation
palpation of the anovaginal distance with two fingers
Perineal ultrasound
ultrasound measurement of the anovaginal distance
Probable grad 3
Perineal laceration Probable grad 3
Bidigital palpation
palpation of the anovaginal distance with two fingers
Perineal ultrasound
ultrasound measurement of the anovaginal distance
Interventions
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Bidigital palpation
palpation of the anovaginal distance with two fingers
Perineal ultrasound
ultrasound measurement of the anovaginal distance
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
FEMALE
No
Sponsors
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Ostergotland County Council, Sweden
OTHER
Responsible Party
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Eva Uustal
Senior consultant
References
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Harvey MA, Pierce M, Alter JE, Chou Q, Diamond P, Epp A, Geoffrion R, Harvey MA, Larochelle A, Maslow K, Neustaedter G, Pascali D, Pierce M, Schulz J, Wilkie D, Sultan A, Thakar R; Society of Obstetricians and Gynaecologists of Canada. Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair. J Obstet Gynaecol Can. 2015 Dec;37(12):1131-48. doi: 10.1016/s1701-2163(16)30081-0.
Geller EJ, Robinson BL, Matthews CA, Celauro KP, Dunivan GC, Crane AK, Ivins AR, Woodham PC, Fielding JR. Perineal body length as a risk factor for ultrasound-diagnosed anal sphincter tear at first delivery. Int Urogynecol J. 2014 May;25(5):631-6. doi: 10.1007/s00192-013-2273-x. Epub 2013 Dec 12.
Santoro GA, Wieczorek AP, Dietz HP, Mellgren A, Sultan AH, Shobeiri SA, Stankiewicz A, Bartram C. State of the art: an integrated approach to pelvic floor ultrasonography. Ultrasound Obstet Gynecol. 2011 Apr;37(4):381-96. doi: 10.1002/uog.8816.
Shobeiri SA, Nolan TE, Yordan-Jovet R, Echols KT, Chesson RR. Digital examination compared to trans-perineal ultrasound for the evaluation of anal sphincter repair. Int J Gynaecol Obstet. 2002 Jul;78(1):31-6. doi: 10.1016/s0020-7292(02)00068-1.
Other Identifiers
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OstergotlandCC2
Identifier Type: -
Identifier Source: org_study_id
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