4.2 Article

In vivo assessment of the elastic properties of the external anal sphincter in term pregnant women using shear wave elastography

Journal

INTERNATIONAL UROGYNECOLOGY JOURNAL
Volume 34, Issue 8, Pages 1705-1713

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s00192-023-05456-x

Keywords

Obstetric anal sphincter injury; External anal sphincter; Shear wave elastography; Perineal trauma; childbirth

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This study aimed to assess the reliability of shear wave elastography in evaluating the elastic properties of the external anal sphincter in term pregnant women. The results showed that shear wave elastography is a reliable tool for this assessment.
Introduction and hypothesisThe objective was to assess the intraobserver intersession and interobserver intrasession reliability of shear wave elastography applied to the external anal sphincter in term pregnant women.MethodsThis prospective study involved nulliparous pregnant women at 37 weeks or more with two visits (V1: one observer; V2 two observers) planned within a 12-h to 7-day interval. Measurements were performed using an Aixplorer V12 (R) device with an SL 18-5 linear probe using a transperineal approach, allowing a measurement of the shear modulus (SM) in kPa. Measures were performed at rest, Valsalva maneuver, and maximal contraction. Reliability was assessed using the intraclass correlation coefficient (ICC). The study was approved by an ethics committee (ID RCB: 2020-A00764-65).ResultsA total of 37 women were included. Intraobserver reliability was excellent at rest (ICC = 0.91 [0.84-0.95) and good during the Valsalva maneuver (ICC = 0.83 [0.72-0.90]) and contraction (ICC = 0.85 [0.75-0.91]). Interobserver reliability was good at rest (ICC = 0.79 [0.66-0.87]) and during Valsalva (ICC = 0.84 [0.73-0.90]), but moderate during contraction (ICC = 0.70 [0.53-0.82]).ConclusionsShear wave elastography is a reliable tool for assessing the elastic properties of the external anal sphincter in term pregnant women.

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