University of Twente Student Theses
Functional ultrasound assessment of external anal sphincter in healthy women and patients with previous obstetric anal sphincter injury
Nijland, D.M. (2023) Functional ultrasound assessment of external anal sphincter in healthy women and patients with previous obstetric anal sphincter injury.
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| Abstract: | Introduction: About 3.5% of women experience an obstetric anal sphincter injury (OASI) at first delivery, damaging the external anal sphincter (EAS). It is still unclear whether women can give birth vaginally in a new pregnancy (with good sphincter repair) or whether a caesarean section is advised to avoid further damaging a weak sphincter. The current ZGT guideline includes symptoms and ultrasound-determined anatomic damage but not EAS function. This study aims to use functional 4D ultrasound to determine the difference in the displacement of the EAS during contraction between women with and without an OASI. Method: In five nullipara women (controls) and five women with a previous OASI (patients), a 4D transperineal ultrasound recording (3D + time) was made of the EAS. Recordings were made from rest to maximal contraction. The EAS was segmented in the rest frame and tracked to maximum contraction. The displacement of the EAS was calculated per voxel in 3 directions (caudal/cranial, anterior/posterior and left/right). These displacements were compared between the control and patient groups. Results: In the caudal/cranial direction, we observe a similar displacement of the EAS between the groups. In the anterior/posterior direction, in the control group, the displacement is highest on the left and right side of the EAS, while in the patient group, this mostly happens only on one side. In addition, in the left/right direction of the control group, the left and right parts are closing, while in the patient group, these parts open. Conclusion: There is a difference in the displacement of the EAS measured by 4D ultrasound between healthy women and women with a previous obstetric anal sphincter injury. These differences support our hypothesis that there are functional differences between the groups and that through transperineal ultrasound, these should be included in the care around OASI. |
| Item Type: | Essay (Master) |
| Clients: | Ziekenhuisgroep Twente, Hengelo, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/96142 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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