ArticleInternational urogynecology journal2025
Transperineal Ultrasound Immediately After Birth to Predict Postpartum Anorectal Dysfunction: A Prospective Cohort Study.
Article in International urogynecology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transperineal ultrasound-based outcomes of postpartum pelvic floor recovery after elective cesarean section versus vaginal delivery: a systematic review and meta-analysis.Frontiers in global women's health · 2026Pooled it
- Feasibility and reproducibility of a novel introital exo-anal ultrasound approach for assessment of the external anal sphincter.Acta obstetricia et gynecologica Scandinavica · 2026Article
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Authors and funding
7 authors.
Funding
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Abstract
introduction and hypothesisTo study the correlation between transperineal ultrasound (TPUS) findings immediately after birth and postpartum anal incontinence (AI) and constipation.
methodsThis is a prospective cohort study in pregnant patients who delivered vaginally at term. Participants filled in questionnaires, including the St. Mark's Incontinence Score and the Patient Assessment of Constipation Symptoms, at inclusion and at 6-weeks postpartum follow-up. TPUS acquisitions were performed immediately after birth to detect anal sphincter and levator defects, the dimensions of the genital hiatus as well as the dimensions of rectovaginal septum defects. We report on the prevalence and severity of AI and constipation at the postpartum follow-up and ran regression models to quantify the association between the former and TPUS findings immediately after birth. We calculated that a minimum of 156 patients were required to detect potential predictors for AI (power = 80%; alpha = 0.05; f
resultsOf 182 consecutive participants, 109 (60%) reported AI and 78 (43%) constipation. There were 37 (20.3%) women with a levator avulsion, 83 (46%) with an external anal sphincter defect in one or more TUI-sections and 29 (16%) with a rectovaginal septum defect. On univariate regression, sphincter defects were associated with AI [OR = 1.94(1.28-2.94)]. On multivariate regression, levator avulsion was the only independent sonographic predictor of AI [aOR = 2.57(1.03-7.44)], whereas sphincter defects, dimensions of the genital hiatus or rectovaginal defects were not correlated with AI. We identified no factors associated with constipation.
conclusionsThe presence of levator avulsion immediately after vaginal delivery predicts postpartum AI. Ultrasound appearance of the anal sphincter, genital hiatus and rectovaginal septum was not informative.
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