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Three-Dimensional Anorectal Manometry Findings in Primigravida

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Abstract

Background

Vaginal delivery is an identified risk factor for anal sphincter injury. Therefore, to identify postpartum injury, an antepartum value or a normal range is required. However, at present, the normal values of 3D manometry are not available for primigravida or pregnant mothers.

Aims

Our study aims at describing normal values of 3D manometry in primigravida.

Methods

We analyzed 3DARM data of 101 consecutive primigravid mothers in the third trimester. 3DARM was performed using the Given Imaging® ManoScan system.

Results

The mean age was 24.7 (SD 5.1) years. All patients had a normal Cleveland Clinic Incontinence Score. The mean resting pressure (RP) was 87.02 (SD 18.43) mmHg and the maximum squeeze pressure (SP) was 179.21 (SD 52.96) mmHg. The mean length of the high-pressure zone (HPZ) was 3.67 (SD 0.52) cm. Mean volumes for initial rectal sensation, urge, and discomfort were 50.36 (±25.57), 76.70 (±35.17), and 143.40 (±66.26) ml, respectively. The pressure asymmetry was highest in the lower anal sphincter and lowest in the mid-sphincter. There was a statistically significant relationship between the HPZ and RP (Pearson ρ −0.23, p = 0.01), height (Pearson ρ 0.22, p = 0.028), and weight (Pearson ρ 0.25, p = 0.012). There were no statistically significant correlations between age, height, or weight with RP, SP, or balloon fill volumes. The characteristic appearance of the normal RP and SP was clearly visualized in all patients.

Conclusions

Normal 3DARM values for Sri Lankan primigravid mothers have been established. These may be used as reference values by other investigators.

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Acknowledgments

This study was supported by a Research Grant and an Infrastructure Development Grant from the University of Colombo. We thank Dr. S. Senaratne for his efforts in coordinating the evaluation of the participants.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 8, Sri Lanka

    D. P. Wickramasinghe, C. S. Perera & D. N. Samarasekera

  2. Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

    H. Senanayake

Authors
  1. D. P. Wickramasinghe
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  2. C. S. Perera
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  3. H. Senanayake
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  4. D. N. Samarasekera
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Correspondence to D. N. Samarasekera.

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Wickramasinghe, D.P., Perera, C.S., Senanayake, H. et al. Three-Dimensional Anorectal Manometry Findings in Primigravida. Dig Dis Sci 60, 3764–3770 (2015). https://doi.org/10.1007/s10620-015-3784-8

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