Bradley Catherine S, Richter Holly E, Gutman Robert E, Brown Morton B, Whitehead William E, Fine Paul M, Hakim Christiane, Harford Frank, Weber Anne M
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA.
Am J Obstet Gynecol. 2007 Sep;197(3):310.e1-5. doi: 10.1016/j.ajog.2007.06.034.
The objective of the study was to identify risk factors for internal anal sphincter (IAS) gaps on postpartum endoanal ultrasound in women with obstetric anal sphincter tear.
This prospective study included 106 women from the Childbirth and Pelvic Symptoms Imaging Supplementary Study who had third- or fourth-degree perineal laceration at delivery and endoanal ultrasound 6-12 months postpartum. Data were analyzed using Fisher's exact and t tests and logistic regression.
Mean (+/- SD) age was 27.7 (+/- 6.2) years. Seventy-nine women (76%) were white and 22 (21%) black. Thirty-seven (35%) had sonographic IAS gaps. Risk factors for gaps included fourth- vs third-degree perineal laceration (odds ratio [OR] 15.4, 95% confidence interval [CI] 4.8, 50) and episiotomy (OR 3.3, 95% CI 1.2, 9.1). Black race (OR 0.23, 95% CI 0.05, 0.96) was protective.
In women with obstetric anal sphincter repairs, fourth-degree tears and episiotomy are associated with more frequent sonographic IAS gaps.
本研究的目的是确定产科肛门括约肌撕裂女性产后经肛门超声检查时肛门内括约肌（IAS）间隙的危险因素。
这项前瞻性研究纳入了106名来自分娩与盆腔症状影像补充研究的女性，她们在分娩时发生了三度或四度会阴裂伤，并在产后6至12个月接受了经肛门超声检查。使用Fisher精确检验、t检验和逻辑回归分析数据。
平均（±标准差）年龄为27.7（±6.2）岁。79名女性（76%）为白人，22名（21%）为黑人。37名（35%）有超声检查发现的IAS间隙。间隙的危险因素包括四度与三度会阴裂伤（比值比[OR]15.4，95%置信区间[CI]4.8，50）和会阴切开术（OR 3.3，95%CI 1.2，9.1）。黑人种族（OR 0.23，95%CI 0.05，0.96）具有保护作用。
在接受产科肛门括约肌修复的女性中，四度撕裂与会阴切开术与更频繁的超声检查发现的IAS间隙相关。
