{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T04:23:50Z","timestamp":1777091030359,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perineal wound infection can affect tissues at superficial, deep, and organ space levels. Women with obstetric anal sphincter injuries (OASIS) are at risk of infection; however, no study to date has investigated if infection can extend to affect the anal sphincter integrity. The aim of this study was to evaluate the clinical progression of perineal wound infection and its effect on the anal sphincter in women with or without OASIS using three\u2010dimensional endoanal ultrasound (3D\u2010EAUS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Women were recruited into the Prospective Observational Study Evaluating the Sonographic Appearance of the Anal Sphincter in Women With Perineal Wound Infection Following Vaginal Delivery (PERINEAL Study) between August 2020 and August 2021 (NCT 04480684). 3D\u2010EAUS was performed weekly until complete wound healing. Significant bacterial colonization was diagnosed using the MolecuLight i:X camera. The primary study outcome was a change in a sphincter defect angle from baseline (wound infection) until wound healing. A robust Poisson regression model was used to analyze the effect of significant bacterial loads on the anal sphincter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010three women were included. A median of two ultrasound scans were performed in each patient (range 1\u201316). Five women (6.8%) had an OASI clinically diagnosed at delivery. In total, 250 EAUS were performed. An external anal sphincter defect was found on EAUS in 55 (22.0%) scans (<jats:italic>n<\/jats:italic>\u00a0=\u00a010 women). An external anal sphincter and internal anal sphincter defect was found in 26 scans (10.4%) (<jats:italic>n<\/jats:italic>\u00a0=\u00a03 women). During the course of the wound healing process, there was no significant change in defect size in wounds with or without significant bacterial colonization. In cases of an intact anal sphincter, wound infection did not disrupt its integrity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found that perineal wound infection does not disrupt an intact anal sphincter or OASIS. This new information can provide important information for clinicians and patients. As there are myths frequently encountered in cases of litigation when disruption of sphincter integrity is attributed to perineal infection, the findings of this study should be tested in larger studies in the future.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14515","type":"journal-article","created":{"date-parts":[[2023,1,28]],"date-time":"2023-01-28T04:46:00Z","timestamp":1674881160000},"page":"473-479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Postpartum perineal wound infection and its effect on anal sphincter integrity: Results of a prospective observational study"],"prefix":"10.1111","volume":"102","author":[{"given":"Nicola Adanna","family":"Okeahialam","sequence":"first","affiliation":[{"name":"Croydon University Hospital  Croydon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranee","family":"Thakar","sequence":"additional","affiliation":[{"name":"Croydon University Hospital  Croydon UK"},{"name":"St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8979-2304","authenticated-orcid":false,"given":"Abdul H.","family":"Sultan","sequence":"additional","affiliation":[{"name":"Croydon University Hospital  Croydon UK"},{"name":"St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.06.048"},{"key":"e_1_2_12_3_1","unstructured":"NHS Litigation Authority.Ten Years of Maternity Claims: An Analysis of NHS Litigation Authority Data.2012Accessed February 8 2021.http:\/\/www.nhsla.com\/safety\/Documents\/Ten%20Years%20of%20Maternity%20Claims%20\u2010%20An%20Analysis%20of%20the%20NHS%20LA%20Data%20\u2010%20October%202012.pdf"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1065-y"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-84628-503-5_9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-84628-503-5_4"},{"key":"e_1_2_12_8_1","unstructured":"European Centre for Disease Prevention and Control.Stockholm. 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