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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Honorary Professor, Honorary Senior Lecturer Ranee Thakar, Croydon University Hospital, UK
- Second opponent: Coordinating Professor Niels Klarskov, University of Copenhagen, Denmark
- Third member and chair of the evaluation committee: Professor Katariina Laine, University of Oslo
Chair of the Defence
Professor Kristina Lindeman, University of Oslo
Principal Supervisor
Professor II Marie Ellström Engh, University of Oslo
Summary
Perineal tears are among the most common birth-related injuries. While severe tears involving the anal sphincter muscle have received considerable attention, second-degree tears affecting the perineal body, are often regarded as uncomplicated. However, some women experience persistent symptoms after these tears, such as sexual dysfunction, a sensation of a wide vagina, bowel emptying difficulties and vaginal flatus. Little is known about how the perineal body anatomy is restored after birth, or whether residual anatomical deviations may be associated with pelvic floor symptoms.
This thesis investigated the use of three-dimensional (3D) ultrasound to assess the perineal body anatomy one year after first childbirth. Using data from the prospective Perineum Study at Akershus University Hospital, it examined the reliability of 3D ultrasound, the association between ultrasound-detected muscle deviations and patient-reported symptoms of pelvic floor dysfunction, and the relationship between muscle deviations and perineal tear severity.
The findings demonstrate that 3D ultrasound is a reliable method for assessing perineal body anatomy. Women with ultrasound-detected muscular deviations had more than twice the odds of reporting a high symptom score compared with women without such deviations. Increasing severity of perineal tears was associated with a higher likelihood of ultrasound-detected deviations in the perineal body.
These findings indicate that anatomical deviations of the perineal body may persist even after less severe perineal tears at delivery and may be associated with symptoms of pelvic floor dysfunction following childbirth.
Additional information
Contact the research support staff.