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The study objective was to assess the utility of three\u2010dimensional endoanal ultrasonography (3D\u2010EAUS) in the diagnosis of OASI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The present study was designed to mirror screening settings with an unselected cohort of nulliparous women. All enrolled patients underwent clinical examination of the perineum by the caregiver, and 3D\u2010EAUS was conducted. Post\u2010processing of ultrasonography volume data was performed by an experienced colorectal surgeon who was blinded to all other data. The sensitivity, specificity, negative predictive value, and positive predictive value of 3D\u2010EAUS in the diagnosis of OASI was evaluated. The trial is registered at ISCRTN: 18006769.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 680 scans were performed, of which 18.5% were judged as \u201cnon\u2010assessable\u201d, resulting in 554 assessable recordings. Sphincter defects were observed in 12.8% of all assessable recordings on 3D\u2010EAUS (<jats:italic>n<\/jats:italic>\u00a0=\u200971). With clinical examination set as the reference standard, ultrasound sensitivity in the diagnosis of OASI was 30.4%, whereas its specificity was 87.9%. The negative predictive value was 96.7% and the positive predictive value was only 9.9%. Comments were left on 175 examinations, of which 74% referred to the management of the examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using 3D\u2010EAUS in a maternity ward is demanding because staff generally have little experience in endoanal ultrasound, which contributes to difficulties in obtaining good image quality. When 3D\u2010EAUS is performed to mirror screening settings, it adds no convincing diagnostic power to clinical examination in the diagnosis of OASI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14514","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:50:20Z","timestamp":1674449420000},"page":"389-395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Use of endoanal ultrasound in detecting obstetric anal sphincter injury immediately after birth"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1792-1944","authenticated-orcid":false,"given":"Malin","family":"Huber","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotta","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences University of Ume\u00e5  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilda","family":"Harrysson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00d6stersund Hospital  \u00d6stersund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Strig\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences University of Ume\u00e5  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010P.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Surgery \u00d6stersund Hospital  \u00d6stersund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4r","family":"Nordin","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences University of Ume\u00e5  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Tun\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01318-7"},{"key":"e_1_2_8_3_1","unstructured":"The Swedish medical birth register 1973\u20132013.Pregnancies deliveries and newborn infants S.O.S.o. 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