title: [Applicability of 3/4D transperineal ultrasound for the diagnosis of anal sphincter injury during the immediate pospartum].
abstract: BACKGROUND
  The most common cause of anal sphincter injuries in women is vaginal birth. Endo-anal ultrasound is currently used for the diagnosis of anal sphincter defect. However, due to the inconvenience caused, it is not an applicable technique during the immediate post-partum. The aim of this study was to determine whether transperineal ultrasound in 3/4D is a useful diagnostic method for the assessment of anal sphincter during the immediate post-partum.
  
  
  METHODS
  A prospective study was conducted on the vaginal deliveries performed between September 2012 and June 2013 in the Valme University Hospital (Seville). Obstetric and foetal parameters that could influence the onset of perineal tears were studied. The patients underwent a transperineal 3/4D ultrasound and a multislice study (48hours after birth).
  
  
  RESULTS
  The study included 146 puerperal women. The sphincter complex was assessed in all of them during the immediate post-partum. External anal injuries were observed in 10.3% of the cases. In 8.2% of cases, the primary suture of the external anal sphincter was detected during ultrasound examination, and 2.1% of asymptomatic lesions were diagnosed only with post-partum ultrasound. None of the patients reported discomfort or pain.
  
  
  CONCLUSIONS
  The 3-dimensional transperineal ultrasound is helpful in determining the primary repair of the anal sphincter during the immediate post-partum, with no discomfort for patients, as well as for establishing those early sphincter injuries that go unnoticed during vaginal delivery.
authors.affiliation: Servicio de Ginecología y Obstetricia, Hospital Universitario de Valme, Sevilla, España. Electronic address: jagmejido@hotmail.com.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: García-Mejido
authors.affiliation: Servicio de Ginecología y Obstetricia, Hospital de Ceuta, Ceuta, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Gutiérrez Palomino
authors.affiliation: Medicina Preventiva y Salud Pública, Universidad de Sevilla, Sevilla, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández Palacín
authors.affiliation: Servicio de Ginecología y Obstetricia, Hospital Universitario de Valme, Sevilla, España.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sainz-Bueno
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries* / Q000601:surgery; D058070:Asymptomatic Diseases; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005113:Extraction, Obstetrical / Q000009:adverse effects; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D061330:Multidetector Computed Tomography; D010502:Perineum / Q000293:injuries; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013536:Suture Techniques; D014463:Ultrasonography / Q000379:methods*; D058106:Wound Closure Techniques; D055815:Young Adult
keywords: 3D transperineal ultrasound; Anal sphincter; Anal sphincter injuries; Anal sphincter suture; Ecografía transperineal 3D; Esfínter anal; Lesiones del esfínter anal; Sutura del esfínter anal