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Development of the anal canal during pregnancy and the postpartum period - a longitudinal and functional ultrasound study.
MedLine Citation:
PMID:  22253200     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives Normal anatomical and physiologic development of the anal canal during and after pregnancy is scarcely documented. Here we study the anal canal, its position and volumes during and after first time pregnancy. Methods Vaginal 3D ultrasound was used in a longitudinal study measuring anatomical structures in the anal canal during rest and squeeze in 23 nulliparous. The total volume of the anal canal, the anorectal curvature (ARC), the anovaginal angle (AVA) and the anal length were determined at 18, 28, and 36 weeks of pregnancy and three months postpartum. Results The total volume of the anal canal at rest increased from average 10.17 to 12.37 and 12.21 cm(3) during pregnancy, p = 0.001 and 0.010 comparing first with second and third measurements. For the anal length the corresponding results were 3.91, 4.07 and 4.21 cm, p = 0.13 and 0.017. Postpartum they were 10.86 cm(3) and 3.90 cm, p = 0.10 and 0.70 compared to first measurement. No significant changes were observed for ARC and AVA during or after pregnancy. Compared to rest position, the anal length significantly increased when squeezing, p = 0.007, 0.007, 0.022, 0.004 at the four time points, while no differences were observed for total volume. In mid-pregnancy the AVA significantly increased during squeeze, p = 0.006 and 0.002 at weeks 18 and 28. Conclusion The length and total volume of the anal canal increased during first completed pregnancy. Voluntary squeezing elongated the anal canal and increased the angle compared with the direction of the vagina. The postpartum involution brought the conditions back to the level found at 18 weeks of pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Ingrid Petrikke Olsen; Tom Wilsgaard; Torvid Kiserud
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-17
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, Hammerfest Hospital, Hammerfest, Norway; Institute of Community Medicine, University of Tromsø, Norway. ingrid.petrikke.olsen@helse-finnmark.no.
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