Anal sphincter function after delivery: a prospective study in women with sphincter rupture and controls

Haadem, Knut; Dahlström, Jan Anders; Lingman, Göran

doi:10.1016/0028-2243(90)90136-o

Cited by 89 publications

(34 citation statements)

References 9 publications

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“…Flatus incontinence has also been associated with a third degree anal sphincter tear, higher maternal age, and instrumental vaginal delivery [6,12,19]. A recent meta-analysis concluded that in 26.9% a disruption of the anal sphincter occurs with the first vaginal delivery [20].…”

Section: Associated Factorsmentioning

confidence: 99%

Defecatory symptoms during and after the first pregnancy: prevalences and associated factors

et al. 2005

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A prospective cohort study was undertaken to evaluate the impact of pregnancy and the first delivery on the defecatory symptoms and to identify associated factors. Included were 487 nulliparous pregnant women who completed four questionnaires. Flatus and fecal incontinence, constipation, and painful defecation are already present in early pregnancy and are significantly predictive for reporting symptoms after delivery, except for fecal incontinence. A third or fourth degree sphincter tear was significantly associated with fecal incontinence 12 months postpartum and with de novo fecal incontinence, while other factors associated with de novo onset of symptoms were of borderline significance. Defecation symptoms already present in early pregnancy are highly predictive for reported symptoms at 12 months postpartum except for fecal incontinence that is mainly related to anal sphincter lesion. Therefore, investigating the effects of childbirth in general on the anorectal function is not justified without knowledge of this function during pregnancy.

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Section: Associated Factorsmentioning

confidence: 99%

Defecatory symptoms during and after the first pregnancy: prevalences and associated factors

et al. 2005

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“…This frequency is lower than in previous studies. Haadem et al 16 reported that 5% of women with clinical sphincter tears suffered faecal incontinence, but no woman without clinically detected tears had symptoms. Sultan et a1.I' found that faecal incontinence occurred in about 9% of women with clinical sphincter tears at delivery and in 2% without.…”

Section: J P Zetterstrom Et a Lmentioning

confidence: 99%

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

Zetterström

López

Anzén

et al. 1999

BJOG

153

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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.

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“…1,3,4 Despite the occurrence of clinically recognizable anal sphincter disruption in approximately 1 to 2 percent of vaginal deliveries, the incidence of occult abnormality apparent on postpartum endoanal ultrasonography is much higher and anal sphincter defects have been reported in 22 to 44 percent of primiparous women after vaginal delivery. 1,5,6 Instrumental delivery and particularly forceps delivery has been shown to double this risk. [7][8][9][10] It is not known whether subsequent vaginal delivery might precipitate significant symptoms of fecal incontinence in women who have evidence of occult anal sphincter injury without significant continence disturbance after first vaginal delivery.…”

mentioning

confidence: 98%

Effect of Second Vaginal Delivery on Anal Function in Patients at Risk of Occult Anal Sphincter Injury after First Forceps Delivery

Mahony¹,

Behan²,

O’Connell³

et al. 2008

Diseases of the Colon &Amp; Rectum

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Anal sphincter function after delivery: a prospective study in women with sphincter rupture and controls

Cited by 89 publications

References 9 publications

Defecatory symptoms during and after the first pregnancy: prevalences and associated factors

Defecatory symptoms during and after the first pregnancy: prevalences and associated factors

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

Effect of Second Vaginal Delivery on Anal Function in Patients at Risk of Occult Anal Sphincter Injury after First Forceps Delivery

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