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
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 E...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000200097&lng=en&tlng=en |
| _version_ | 1818493044252475392 |
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| author | Miriam Raquel Diniz Zanetti Carla Dellabarba Petricelli Sandra Maria Alexandre Aline Paschoal Edward Araujo Júnior Mary Uchiyama Nakamura |
| author_facet | Miriam Raquel Diniz Zanetti Carla Dellabarba Petricelli Sandra Maria Alexandre Aline Paschoal Edward Araujo Júnior Mary Uchiyama Nakamura |
| author_sort | Miriam Raquel Diniz Zanetti |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T17:50:05Z |
| format | Article |
| id | doaj.art-07977b8e0ad84c619687e3a6c184fee2 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-10T17:50:05Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-07977b8e0ad84c619687e3a6c184fee22022-12-22T01:39:05ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-946013429710210.1590/1516-3180.2014.8581009S1516-31802016000200097Determination 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 studyMiriam Raquel Diniz ZanettiCarla Dellabarba PetricelliSandra Maria AlexandreAline PaschoalEdward Araujo JúniorMary Uchiyama NakamuraCONTEXT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000200097&lng=en&tlng=enPhysical therapy modalitiesPelvic floorPerineumLabor stage, firstParturition |
| spellingShingle | Miriam Raquel Diniz Zanetti Carla Dellabarba Petricelli Sandra Maria Alexandre Aline Paschoal Edward Araujo Júnior Mary Uchiyama Nakamura 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 São Paulo Medical Journal Physical therapy modalities Pelvic floor Perineum Labor stage, first Parturition |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Physical therapy modalities Pelvic floor Perineum Labor stage, first Parturition |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802016000200097&lng=en&tlng=en |
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