Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 50 min ago
Peer-reviewedCC BYRevista da Associacao Medica Brasileira (1992)

Intrapartum rectovaginal distance as a predictor of obstetric anal sphincter injury: a prospective cohort study.

  • Elif Görkem Bademci1
  • Yağmur Şimşek Erdim2
  • Ecem Yüksel Özsoy3
  • Erkan Elçi4
4 affiliations
  1. 1Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Department of Gynecology and Obstetrics - Istanbul, Turkey.
  2. 2Sisli Hamidiye Etfal Training and Research Hospital, Department of Gynecology and Obstetrics - Istanbul, Turkey.
  3. 3Darıca Farabi Training and Research Hospital, Department of Gynecology and Obstetrics - Kocaeli, Turkey.
  4. 4Medicana Atakoy Hospital, Department of Gynecology and Obstetrics - Istanbul, Turkey.
Read full textPDFDOICite

Abstract

Objective

The aim of this study was to evaluate the relationship between intrapartum rectovaginal distance measured by transperineal ultrasonography and obstetric anal sphincter injury severity and second-stage labor duration in nulliparous women undergoing vaginal delivery.Methods

This prospective cohort study was conducted at a tertiary referral center in Istanbul, between September 2021 and January 2022. Of 200 consecutive nulliparous women with singleton pregnancies at ≥37 weeks' gestation, 148 who underwent vaginal delivery were included in the primary analysis. Intrapartum rectovaginal distance was measured in the midsagittal plane by 2D transperineal ultrasonography using a single operator during the inter-contraction rest period, at a fetal head station ranging from -1 to +1. Angle of progression and levator ani anteroposterior diameter were also recorded. Obstetric injury was graded per American College of Obstetricians and Gynecologists 2016 criteria; grade 3-4 laceration (severe obstetric anal sphincter injury) was the primary outcome.Results

Severe obstetric anal sphincter injury occurred in 18 vaginal deliveries (12.2%). Rectovaginal distance was significantly shorter in women with severe obstetric anal sphincter injury (6.91±1.33 mm vs. 9.94±2.75 mm, p<0.001). Second-stage duration was longer with severe obstetric anal sphincter injury (125.8±6.5 vs. 91.3±18.0 min, p<0.001). Receiver operating characteristic analysis identified an rectovaginal distance cut-off of 8.1 mm (AUC=0.846; sensitivity 88.9%, specificity 80.8%). On multivariate logistic regression, rectovaginal distance (OR 0.516, 95%CI 0.373-0.713) and body mass index (OR 1.280, 95%CI 1.078-1.521) were independently associated with severe obstetric anal sphincter injury.Conclusion

Intrapartum rectovaginal distance measurement by transperineal ultrasonography is a noninvasive, readily obtainable parameter that independently predicts severe obstetric anal sphincter injury and may support individualized intrapartum risk stratification. Multicenter validation with larger samples is warranted.

Related

  1. Improving Immediate Postpartum Detection of Obstetric Anal Sphincter Injury: Added Diagnostic Value of Impedance Spectroscopy Following Clinical Assessment
    M. Uchman Musielak, K. Kleczkowska, I. Sudol Szopinska +1
    medRxivPreprintAll rights reservedFull text1 citedObstetrics, gynaecology & paediatricsmedRxiv
  2. Real-World Adaptation and External Validation of Machine-Learning Impedance Spectroscopy for Immediate Postpartum Detection of Obstetric Anal Sphincter Injuries
    M. Mlynczak, K. Korzeniewski, M. Rosol +7
    medRxivPreprintAll rights reservedFull textObstetrics, gynaecology & paediatricsmedRxiv
  3. Lived experiences of obstetric anal sphincter injury among women from ethnically diverse backgrounds in the UK: a qualitative study.
    Olufisayo Olakotan, Jennifer N W Lim, Mina Bhavsar +4
    Frontiers in global women's healthPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. Perineal Body Reconstruction for Anal Sphincter Insufficiency Following Obstetric Perineal Body Injury: Morphology-based Classification and Type-stratified Outcomes in 42 Cases.
    Koichiro Murakami, Yumi Nishimura, Tomoyuki Mizukuro
    Journal of the anus, rectum and colonPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMCPMC
  5. Mixed-Effects Machine Learning improved prediction of Obstetric Anal Sphincter Injury: a nationwide multicenter cohort study.
    A. Chahid Mohamed, A. C. Ravelli, J. de Leeuw +2
    medRxivPreprintCC BYFull textObstetrics, gynaecology & paediatricsmedRxiv

Cite

BibTeXRIS
BibTeX
@article{bademci2026intrapartum,
  title = {{Intrapartum rectovaginal distance as a predictor of obstetric anal sphincter injury: a prospective cohort study.}},
  author = {Elif Görkem Bademci and Yağmur Şimşek Erdim and Ecem Yüksel Özsoy and Erkan Elçi},
  journal = {Revista da Associacao Medica Brasileira (1992)},
  year = {2026},
  month = oct,
  doi = {10.1590/1806-9282.20260531},
  url = {https://europepmc.org/article/MED/42912052},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Intrapartum rectovaginal distance as a predictor of obstetric anal sphincter injury: a prospective cohort study.
AU  - Elif Görkem Bademci
AU  - Yağmur Şimşek Erdim
AU  - Ecem Yüksel Özsoy
AU  - Erkan Elçi
PY  - 2026
DA  - 2026/10/12
JO  - Revista da Associacao Medica Brasileira (1992)
DO  - 10.1590/1806-9282.20260531
UR  - https://europepmc.org/article/MED/42912052
AB  - Objective  The aim of this study was to evaluate the relationship between intrapartum rectovaginal distance measured by transperineal ultrasonography and obstetric anal sphincter injury severity and second-stage labor duration in nulliparous women undergoing vaginal delivery.Methods  This prospective cohort study was conducted at a tertiary referral center in Istanbul, between September 2021 and January 2022. Of 200 consecutive nulliparous women with singleton pregnancies at ≥37 weeks' gestation, 148 who underwent vaginal delivery were included in the primary analysis. Intrapartum rectovaginal distance was measured in the midsagittal plane by 2D transperineal ultrasonography using a single operator during the inter-contraction rest period, at a fetal head station ranging from -1 to +1. Angle of progression and levator ani anteroposterior diameter were also recorded. Obstetric injury was graded per American College of Obstetricians and Gynecologists 2016 criteria; grade 3-4 laceration (severe obstetric anal sphincter injury) was the primary outcome.Results  Severe obstetric anal sphincter injury occurred in 18 vaginal deliveries (12.2%). Rectovaginal distance was significantly shorter in women with severe obstetric anal sphincter injury (6.91±1.33 mm vs. 9.94±2.75 mm, p<0.001). Second-stage duration was longer with severe obstetric anal sphincter injury (125.8±6.5 vs. 91.3±18.0 min, p<0.001). Receiver operating characteristic analysis identified an rectovaginal distance cut-off of 8.1 mm (AUC=0.846; sensitivity 88.9%, specificity 80.8%). On multivariate logistic regression, rectovaginal distance (OR 0.516, 95%CI 0.373-0.713) and body mass index (OR 1.280, 95%CI 1.078-1.521) were independently associated with severe obstetric anal sphincter injury.Conclusion  Intrapartum rectovaginal distance measurement by transperineal ultrasonography is a noninvasive, readily obtainable parameter that independently predicts severe obstetric anal sphincter injury and may support individualized intrapartum risk stratification. Multicenter validation with larger samples is warranted.
SN  - 0104-4230
SN  - 1806-9282
ER  -