Right mediolateral episiotomy and anal sphincter injury in primiparous women during delivery

摘要: Hypothesis / aims of study: Anal incontinence (AI) is devastating condition in women after delivery. It was estimated that it affects 0,17% aged 15 to 64 and 1,3-11 % over years age. The causes anal can be different. main cause trauma due role the episiotomy prevention uncertain. A systematic review concluded effect on development pelvic floor disorders remains unknown. The surgical enlargement vaginal orifice by an incision perineum during last part second stage labour. This procedure done with scissors or scalpel requires repair suturing. There are different ways performing episiotomy, midline, mediolateral, lateral left right. Although one most commonly performed procedures world, introduced without scientific evidence its effectiveness. In our country midwife expedite delivery case fetal distress, increase area passage, breech position, instrumental delivery, minimize risk sphincter injury. almost always right side. few exceptions where they do side midline. incidence primiparous around 50 40% all deliveries. Anal injury clinically diagnosed short important factor subsequent incontinence. Many authors described endoanal ultrasound as suitable method evaluate anatomy. Ultrasound examination childbirth improves diagnoses tears, enables their immediate decreases severe fecal incontinence. OASI linked midline episiotomies mediolateral post-delivery angles 60 degrees We wanted know if there some other factors than angle could influence anal Study design, materials methods. study randomized controlled prospective. recruited were pregnant nulliparous 28-33 weeks who came routine check gynecological outpatient department. The participants examined twice: First 28--32 pregnancy 6-7 when volunteers back examination. Imaging using a crystal probe such B&K Medical scanner (B&K Medical, Sandhoften, Denmark). inserted into canal 3D scan done. Data analyzed Wilcoxon rank sum test for equal medians. Results: Sixty-five completed both examinations pre post partum. Thirty-two had No differences observed global parameters age, weight, BMI infant weight between patients episiotomy. Within group significant shorter length visible (p<0.05), while no episiotomy. Interpretation results: does not provide sufficient stray forces away from sphincter. Probably we didn’t find connection because range 40 degrees. Concluding message: Short associated decide perform should long.