Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, S-581 85 Linköping, Sweden.
Biomed Res Int. 2018 Mar 7;2018:1532949. doi: 10.1155/2018/1532949. eCollection 2018.
To evaluate if there was a difference in the anovaginal distance (AVD) measured by transperineal ultrasound between obese and normal weight women.
A prospective observational study including 207 primiparous women at term in first stage of labor. Transperineal ultrasound with a vaginal probe was used to measure the AVD. Maternal, pregnancy, and delivery characteristics potentially associated with perineal thickness were extracted from woman's medical records. The participants were divided into three BMI groups based on maternal weight in early pregnancy: normal weight (BMI < 25), overweight (BMI 25-29.9), and obesity (BMI ≥ 30). Obese and overweight women were compared with normal weight women regarding the AVD.
The mean AVD was 24.3, 24.9, and 27.0 mm in the normal weight, overweight, and obesity group, respectively. There were no group differences in background characteristics. The AVD was significantly longer in obese women compared with normal weight women ( = 0.018).
The observed longer AVD in obese women might be protective of the anal sphincter complex, explaining lower rates of anal sphincter injuries in this group. Further studies are indicated to evaluate whether the length of the AVD plays a role in the risk assessment of obstetric anal sphincter injury. The trial is registered in ClinicalTrials.gov and the trial registration ID is NCT03149965.
评估经会阴超声测量的肥胖和正常体重女性的阴道直肠间隔（AVD）是否存在差异。
这是一项前瞻性观察性研究，纳入了 207 名初产妇，均处于第一产程足月阶段。采用经会阴超声联合阴道探头测量 AVD。从女性病历中提取与会阴厚度相关的母体、妊娠和分娩特征。根据孕妇早孕时的体重，将参与者分为三组 BMI：正常体重（BMI＜25）、超重（BMI 25-29.9）和肥胖（BMI≥30）。比较肥胖和超重妇女与正常体重妇女的 AVD。
正常体重、超重和肥胖组的平均 AVD 分别为 24.3、24.9 和 27.0mm。三组间背景特征无组间差异。肥胖组的 AVD 明显长于正常体重组（ = 0.018）。
肥胖女性观察到的较长 AVD 可能对肛门括约肌复合体具有保护作用，这可以解释该组中肛门括约肌损伤发生率较低的原因。需要进一步研究评估 AVD 的长度是否在评估产科肛门括约肌损伤风险中发挥作用。该试验已在 ClinicalTrials.gov 注册，试验注册号为 NCT03149965。
