Anal incontinence after vaginal delivery: a prospective study in primiparous women

Abstract

Objective To investigate the incidence and degree of anal incontinence after vaginal delivery among Design Prospective observational study.Setting Karolinska Institutet, Danderyd Hospital, Sweden, a university hospital.Participants Three hundred and forty-nine primiparous women.Methods Questionnaires distributed within the first days after delivery and re-distributed five and nine months postpartum. Analysis of delivery records.Results Eighty percent of the women answered all questionnaires. At five months postpartum, 2% of the women had symptoms of faecal incontinence and 25% had symptoms of involuntary flatus. At nine months postpartum, 1 % of the women had symptoms of faecal incontinence and 26% had symptoms of involuntary flatus. The majority of the women had infrequent symptoms and a decrease in severity was noted at nine months. Symptoms of incontinence were more common in women who sustained a sphincter tear at delivery. Risk factors for incontinence at five months included maternal age, duration of the second stage of labour, instrumental vaginal delivery, and clinically diagnosed sphincter tear at delivery. Development of incontinence at nine months was associated with maternal age and clinically diagnosed sphincter tear at delivery. ConclusionsThe present study demonstrates that infrequent involuntary flatus is a common symptom after vaginal delivery in primiparous women. These symptoms of involuntary flatus frequently improved and only a few women suffered from frank faecal incontinence. Factors associated with an increased risk of anal incontinence and sphincter tears should be considered during delivery.primiparous women and to define associated risk factors.

Prevalence of postpartum anal incontinence: a cross sectional study in Northern Sri Lanka

“…A study has shown that increasing maternal age as a risk factor for developing anal incontinence after delivery [13]. But our study demonstrated an opposite finding to this.…”

The impact of fecal and urinary incontinence on quality of life 6 months after childbirth

“…The Hunskaar score 13 described UI severity as the product of the frequency and volume of incontinent episodes (range 0-12). Severity categories are: continent (0), slight (1-2), moderate (3-6), severe (7)(8)(9), and very severe (10)(11)(12).…”

“…2,3,7 The Pelvic Floor Disorders Network (PFDN) has previously published findings of the Childbirth and Pelvic Symptoms (CAPS) study, 8 which examined the prevalence of FI and UI in 3 cohorts of primiparous women. FI was more prevalent (17.0%) in women who delivered vaginally with recognized anal sphincter tears, compared with women who delivered Reprints not available from the authors.…”

Associação entre via de parto e complicações maternas em hospital público da Grande São Paulo, Brasil

“…Outros autores estudaram as repercussões de longo prazo relacionadas ao tipo de parto. Descreve-se maior incidência de perda urinária de esforço 33 e incontinência fecal 34 associadas ao parto vaginal, especialmente com o vaginal operatório, e maior risco de placenta prévia, descolamento prematuro de placenta 35 e rotura uterina 36 em gestações subseqüentes associados à cesárea. Thompson et al 37 organizaram uma coorte que acompanhou mulheres 8, 16 e 24 semanas após o parto e avaliou, por meio de questionário respondido pelas mulheres, a freqüência de sintomas subjetivos e reinternação.…”