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Determination of a cutoff value for pelvic floor distensibility using the Epi-no balloon to predict perineal integrity in vaginal delivery: ROC curve analysis. Prospective observational single cohort study.
Zanetti, Miriam Raquel Diniz; Petricelli, Carla Dellabarba; Alexandre, Sandra Maria; Paschoal, Aline; Araujo Júnior, Edward; Nakamura, Mary Uchiyama.
Afiliação
  • Zanetti MR; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Petricelli CD; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Alexandre SM; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Paschoal A; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Araujo Júnior E; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Nakamura MU; Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Brazil.
Sao Paulo Med J ; 134(2): 97-102, 2016 Apr.
Article em En | MEDLINE | ID: mdl-25789777
CONTEXT AND OBJECTIVE: Several risk factors are involved in perineal lacerations during vaginal delivery. However, little is known about the influence of perineal distensibility as a protective factor. The aim here was to determine a cutoff value for pelvic floor distensibility measured using the Epi-no balloon, which could be used as a predictive factor for perineal integrity in vaginal delivery. DESIGN AND SETTING: Prospective observational single cohort study conducted in a maternity hospital. METHODS: A convenience sample of 227 consecutive at-term parturients was used. All women had a single fetus in the vertex presentation, with up to 9.0 cm of dilation. The maximum dilation of the Epi-no balloon was measured using a tape measure after it had been inflated inside the vagina up to the parturients' maximum tolerance. The receiver operating characteristic (ROC) curve was used to obtain the Epi-no circumference measurement with best sensitivity and specificity. RESULTS: Among the 161 patients who were included in the study, 50.9% underwent episiotomy, 21.8% presented lacerations and 27.3% retained an intact perineum. Age > 25.9 years; number of pregnancies > 3.4; number of deliveries > 2.2 and circumference measured by Epi-no > 21.4 cm were all directly correlated with an intact perineum. Circumference measurements using the Epi-no balloon that were greater than 20.8 cm showed sensitivity and specificity of 70.5% and 66.7% (area under curve = 0.713), respectively, as a predictive factor for an intact perineum in vaginal delivery. CONCLUSION: Circumferences greater than 20.8 cm achieved using the Epi-no balloon are a predictive factor for perineal integrity in parturients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Períneo / Diafragma da Pelve / Parto Obstétrico / Força Muscular / Complicações do Trabalho de Parto Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Sao Paulo Med J Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Períneo / Diafragma da Pelve / Parto Obstétrico / Força Muscular / Complicações do Trabalho de Parto Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Sao Paulo Med J Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil