Pihl Sofia, Uustal Eva, Hjertberg Linda, Blomberg Marie
Department of Obstetrics and Gynaecology, Linköping University, SE-581 85, Linköping, Sweden.
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Int Urogynecol J. 2018 May;29(5):697-701. doi: 10.1007/s00192-017-3392-6. Epub 2017 Jun 17.
Objective outcome measures of the extent of laceration at delivery are needed. In this study we evaluated and describe here a method for learning perineal ultrasound measurement of the anovaginal distance (AVD). The learning period needed for examiners proficient in vaginal ultrasound examination and the interobserver agreement after reaching proficiency in AVD measurement were determined. The hypothesis was that the method is feasible to learn and reproducible for use in further research.
The method was taught by an examiner experienced in perineal ultrasonography. The distance between the mucosal margin of the internal anal sphincter was measured with a vaginal probe. The studied examiners measured the AVD until similar results (±5 mm) were achieved. The AVD in 40 women was then measured and documented by two examiners who were blinded to each other's results. Interobserver agreement was calculated using the kappa score.
Examiners with previous experience in vaginal ultrasonography had learned the method after performing five sets of comeasurements. The AVD measurements after the learning period showed almost perfect agreement (κ = 0.87) between the examiners.
The method for perineal ultrasound measurement of AVD was learned quickly with high interobserver agreement. The method is feasible to learn and reproducible for use in further research.
分娩时裂伤程度的客观结局指标很有必要。在本研究中，我们评估并描述了一种学习经会阴超声测量肛阴道距离（AVD）的方法。确定了精通阴道超声检查的检查者所需的学习期以及在掌握AVD测量技能后观察者间的一致性。假设该方法对于学习而言是可行的，并且可重复用于进一步的研究。
该方法由一位有会阴超声检查经验的检查者进行传授。使用阴道探头测量肛门内括约肌黏膜边缘之间的距离。参与研究的检查者测量AVD，直至获得相似结果（±5毫米）。随后由两名彼此不知道对方结果的检查者对40名女性的AVD进行测量并记录。使用kappa评分计算观察者间的一致性。
有阴道超声检查经验的检查者在进行五组联合测量后学会了该方法。学习期后的AVD测量显示检查者之间几乎完全一致（κ = 0.87）。
经会阴超声测量AVD的方法学习起来很快，观察者间一致性很高。该方法对于学习而言是可行的，并且可重复用于进一步的研究。
