E-Posters-Clinical Diagnosis of Obstetric Anal Sphincter Injury: How Accurate is it?

Clinical Diagnosis of Obstetric Anal Sphincter Injury: How Accurate is it? - Moshe Gillor, MD, PhD

Pdf Summary

The study aimed to evaluate the accuracy of clinical diagnosis compared to diagnosis using translabial ultrasound (TLUS) for obstetric anal sphincter injury (OASI). A retrospective study was conducted on 260 patients who had recently experienced OASI between July 2012 and May 2018. The OASI grading was documented by the treating obstetrician according to RCOG guidelines. TLUS was used to evaluate the external and internal sphincters, with abnormal slices indicating abnormalities in these areas. An algorithm was used to distinguish different grades of tears. <br /><br />The study found fair agreement between clinical and TLUS diagnosis of OASI. Clinical over-diagnosis was observed in approximately 33% of cases, while potential under-diagnosis was seen in 17% of cases. The agreement between clinical and sonographic grading did not significantly differ based on the seniority of the diagnosing obstetrician. <br /><br />Additionally, the study reported that 11% of women had a normal sphincter on imaging despite being clinically diagnosed with tears. <br /><br />Overall, the findings suggest that clinical diagnosis of OASI may be prone to both over-diagnosis and under-diagnosis. TLUS may provide a more accurate assessment of OASI and could be considered as a complementary tool in diagnosing and grading OASI.

Keywords

accuracy

clinical diagnosis

translabial ultrasound

OASI

retrospective study

OASI grading

tears grading

over-diagnosis

under-diagnosis

complementary tool