Cvetkov D L, Stoykov S, Ignatov P, Lukanovic A
Akush Ginekol (Sofiia). 2016;55(4):9-13.
introduction The overall risk of intrapartum damage the anal sphincter (IUAS) is 1% of all vaginal births. In contrast, the so-called "occult" anal sphincter injuries (OASIS) (defects esablished by endoanal ultrasonography) occur in 33% of primiparous women after vaginal birth. Identifying the most common risk factors for OASIS can be the basis for selecting high-risk patients. These women should be targeted by early pospartum diagnosis and treatment, which could reduce the incidence of anal incontinence developed later in life. Objectives To determine the role of common risk factors for the occurrence of OASIS in selected population. Material and methods The study included 42 patients after vaginal birth, born in Maternity Ljubljana in the period January to June 2009, and 38 patients from July 2009 to November 2011, born in Obstetric Clinic of the University Hospital - Pleven, diagnosed with OASIS using endoanal ultrasonography. Results We demonstrated that all of the independent variables studied in our research (primiparity, gestational age over 41gw and fetal weight over 3500 g.) are risk factors for the occurrence of OASIS. Discussion This sudy shows that the sudied risk factors for the occurrence of OASIS may be included in a clinical practice guideline for eady diagnosis and proper treatment of posTpartal injuries affecting the pelvic floor.
引言 分娩时损伤肛门括约肌（IUAS）的总体风险在所有阴道分娩中为1%。相比之下，所谓的“隐匿性”肛门括约肌损伤（OASIS）（通过肛门内超声检查确定的缺陷）在初产妇阴道分娩后发生率为33%。确定OASIS最常见的风险因素可为选择高危患者提供依据。这些女性应成为产后早期诊断和治疗的对象，这可能会降低日后生活中肛门失禁的发生率。目的 确定选定人群中OASIS发生的常见风险因素的作用。材料与方法 该研究纳入了2009年1月至6月在卢布尔雅那妇产科出生的42例阴道分娩患者，以及2009年7月至2011年11月在普列文大学医院产科诊所出生、经肛门内超声检查诊断为OASIS的38例患者。结果 我们证明，我们研究中的所有独立变量（初产、孕周超过41周加零天和胎儿体重超过3500克）都是OASIS发生的风险因素。讨论 本研究表明，所研究的OASIS发生风险因素可纳入临床实践指南，以早期诊断和恰当治疗影响盆底的产后损伤。
