Department of Obstetrics, Gynecology & Neonatology, Sydney Medical School Nepean, The University of Sydney, 62 Derby Street, Kingswood, NSW, 2747, Australia.
Int Urogynecol J. 2021 Jul;32(7):1953-1962. doi: 10.1007/s00192-020-04669-8. Epub 2021 Feb 17.
The term 'maternal birth trauma' has undergone substantial changes in meaning over the last 2 decades. Leaving aside psychological morbidity, somatic trauma is now understood to encompass not just episiotomy, perineal tears and obstetric anal sphincter injuries (OASI), but also trauma to the levator ani muscle. This review covers diagnosis of maternal birth trauma by translabial ultrasound imaging.
Narrative review.
Tomographic imaging of pelvic structures with the help of 4D ultrasound, used since 2007, has allowed international standardization and seems to be highly reproducible and valid for the diagnosis of OASI and levator avulsion.
Translabial and exo-anal ultrasound allows the assessment of maternal birth trauma in routine clinical practice and the utilization of avulsion and sphincter trauma as key performance indicators of maternity services. It is hoped that this will lead to a greater awareness of maternal birth trauma among maternity caregivers and improved outcomes for patients, both in the short term and in the decades to come.
“产妇分娩创伤”一词在过去 20 年中经历了重大的词义变化。除了心理病态之外,躯体创伤现在不仅包括会阴切开术、会阴撕裂和产科肛门括约肌损伤(OASI),还包括提肛肌创伤。本综述涵盖经阴道超声成像对产妇分娩创伤的诊断。
叙述性综述。
自 2007 年以来,借助 4D 超声对骨盆结构进行断层成像,实现了国际标准化,并且似乎对 OASI 和提肛肌撕裂的诊断具有高度的可重复性和有效性。
经阴道和经肛超声可在常规临床实践中评估产妇分娩创伤,并将撕裂伤和括约肌创伤用作产妇服务的关键绩效指标。希望这将提高产妇保健护理人员对产妇分娩创伤的认识,并改善患者的短期和未来几十年的治疗效果。