Evidence map›Paper›PMID 37350333›Full record

ArticleActa obstetricia et gynecologica Scandinavica2023

Sonographic postpartum anal sphincter defects and the association with pelvic floor pain and dyspareunia.

Malin Huber, Charlotta Larsson, Jan-P Lehmann, Karin Strigård, Anna Lindam, Katarina Tunón

Open access · diamondAbstract read
In one paragraph

Article in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Understanding and addressing female pelvic pain - a multifaceted challenge.Acta obstetricia et gynecologica Scandinavica · 2023
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Malin HuberDepartment of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.ORCID 0000-0002-1792-1944
Charlotta LarssonDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Jan-P LehmannDepartment of Surgery, Östersund Hospital, Östersund, Sweden.
Karin StrigårdDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Anna LindamUnit of Research, Education and Development, Department of Public Health and Clinical Medicine, Östersund Hospital, Umeå University, Umeå, Sweden.ORCID 0000-0002-6230-0354
Katarina TunónDepartment of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
Umeå University · SEÖstersunds Hospital · SE

Funding

Unit of Research, Education and Development, Region Jämtland-HärjedalenVisareNorr, Northern County Council, Sweden
6 · The paper itself

Abstract

introductionPelvic floor pain and dyspareunia are both important entities of postpartum pelvic pain, often concomitant and associated with perineal tears during vaginal delivery. The association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia has not been fully established. We aimed to determine the prevalence of postpartum anal sphincter defects using three-dimensional endoanal ultrasonography (3D-EAUS) and evaluate their association with symptoms of pelvic floor pain and dyspareunia. MATERIAL AND

methodsThis prospective cohort study followed 239 primiparas from birth to 12 months post delivery. Anal sphincters were assessed with 3D-EAUS 3 months postpartum, and self-reported pelvic floor function data were obtained using a web-based questionnaire distributed 1 year after delivery. Descriptive statistics were compared between the patients with and without sonographic defects, and the association between sonographic sphincter defects and outcomes were analyzed using logistic regression.

resultsAt 3 months postpartum, 48/239 (20%) patients had anal sphincter defects on 3D-EAUS, of which 43 (18%) were not clinically diagnosed with obstetric anal sphincter injury at the time of delivery. Patients with sonographic defects had higher fetal weight than those without defects, and a perineum <2 cm before the suture was a risk factor for defects (odds ratio [OR], 6.9). Patients with sonographic defects had a higher frequency of dyspareunia (OR, 2.4), and pelvic floor pain (OR, 2.3) than those without defects.

conclusionsOur results suggest an association between postpartum sonographic anal sphincter defects, pelvic floor pain, and dyspareunia. A perineal height <2 cm, measured by bidigital palpation immediately postdelivery, was a risk factor for sonographic anal sphincter defect. We suggest offering pelvic floor sonography around 3 months postpartum to high- risk women to optimize diagnosis and treatment of perineal tears and include perineum <2 cm prior to primary repair as a proposed indication for postpartum follow-up sonography.

Indexed as

DyspareuniaFecal IncontinenceLacerationsAnal CanalDelivery, ObstetricFemaleHumansPelvic FloorPelvic PainPostpartum PeriodPregnancyProspective StudiesUltrasonographyanal sphincter defectdyspareuniapelvic floorperineal pain

Identifiers

PMID37350333
PMCPMC10540925
OpenAlexW4381715778

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.