{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T07:50:01Z","timestamp":1776844201085,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,7,30]],"date-time":"2012-07-30T00:00:00Z","timestamp":1343606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if anatomic primary repair with end\u2010to\u2010end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared with conventional primary end\u2010to\u2010end repair in which the IAS is not actively reconstructed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women who sustained third\u2010 or fourth\u2010degree obstetric tears were included prospectively in the study following anatomic primary repair. Women treated with conventional primary repair prior to the study period comprised the control group. Three\u2010dimensional endoanal ultrasonography (3D\u2010EAUS) images were classified according to the EAUS defect score, and incontinence according to St Mark's score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010three women were included in the study group and 61 in the control group, with mean follow\u2010up times of 11 and 21 months, respectively. Among women who had not delivered vaginally prior to the tear, St Mark's score \u2265 3 was reported by 9.6% (5\/52) in the study group and 37.5% (15\/40) in the control group at follow\u2010up (<jats:italic>P<\/jats:italic> = 0.002). The corresponding numbers among women who had previously delivered vaginally were 36.4% (4\/11) and 42.9% (9\/21), respectively (non\u2010significant). St Mark's score correlated with the EAUS defect score (<jats:italic>P<\/jats:italic> = 0.017). An EAS defect exceeding 50% of the sphincter length was significantly less common in the study group, and in a multivariable logistic regression model, mode of repair (anatomic <jats:italic>vs<\/jats:italic> conventional) was the only factor explaining the difference in EAS sphincter length between the two groups (<jats:italic>P<\/jats:italic> = 0.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Improved continence status after anatomic primary repair was associated with a better longitudinal reconstruction of the EAS, while the integrity of the IAS did not differ between the groups. Women with a history of vaginal delivery prior to the sphincter tear had an inferior outcome regardless of mode of repair. Copyright \u00a9 2012 ISUOG. 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A modified approach to obstetric anal sphincter injury","volume":"10","author":"Lindqvist PG","year":"2010","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.10154","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.10154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T08:49:06Z","timestamp":1696668546000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.10154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7,30]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1002\/uog.10154"],"URL":"https:\/\/doi.org\/10.1002\/uog.10154","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7,30]]},"assertion":[{"value":"2011-11-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-07-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}