Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair

Zetterström, Jan; López, Annika; Anzén, Bo; Norman, M; Holmström, Bo; Mellgren, Anders

doi:10.1016/s0029-7844(99)00248-3

Cited by 179 publications

(149 citation statements)

References 27 publications

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“…Others studying incontinence at 3-12 months or at 1-5 years after primary repair of an obstetric sphincter tear found similar results with 40-59% of the women having anal incontinence 2,6,9,11,12,21 . In our study the incontinence score increased with time.…”

Section: Discussionmentioning

confidence: 75%

“…According to published studies, most women with anal incontinence after an obstetric sphincter tear are incontinent for gas only (gas incontinence/stool incontinence ratio of 5 : 1) 8,12,21,28 . In a 30-year retrospective study of women in three groups (obstetric anal sphincter tear, episiotomy, Cesarean delivery) 16 a surprisingly large number of middle-aged women had anal incontinence.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, information on anal incontinence before an obstetric sphincter tear has been collected in only one published study 12 . In that study 15% of the women were incontinent before the tear (13% reporting flatus incontinence and 2% fecal incontinence), which is less than in our study.…”

Section: Discussionmentioning

confidence: 99%

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The extent of endosonographic anal sphincter defects after primary repair of obstetric sphincter tears increases over time and is related to anal incontinence

Starck

Bohe

Valentin

2006

Ultrasound Obstet Gynecol

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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The extent of endosonographic anal sphincter defects after primary repair of obstetric sphincter tears increases over time and is related to anal incontinence

Starck

Bohe

Valentin

2006

Ultrasound Obstet Gynecol

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“…A study from Sweden reported that prelabor intervention (induction of labor) if the expected birth weight was more than 4000 g was prevalent [13]. As a result of complications due to LGA or the risk factors that lead to induction of labor for LGA babies, there was an increased risk of cesarean sections, of frequent use of episiotomy, or instrumental delivery and of the increased perineal rupture [10,11,14,15]. Therefore, the objectives of this study were to describe the change in the rate of LGA from 1996 to 2010 in India and to study the association between specific maternal risk factors for LGA.…”

Section: Introductionmentioning

confidence: 99%

Large for Gestational Age Births Among South Indian Women: Temporal Trend and Risk Factors from 1996 to 2010

Jeyaseelan

Yadav

Silambarasan

et al. 2015

J Obstet Gynecol India

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Background/Purpose Mean birth weight is a good health indicator for any population. In the recent past, there have been many reports in the West indicating that there has been an increase in the proportion of large for gestational age (LGA) babies. The objective is to describe the change in the incidence of LGA babies from 1996 to 2010 in South India and the maternal risk factors. Methods A rotational sampling scheme was used, i.e., the 12 months of the year were divided into 4 quarters and a month was from each quarter was selected rotationally. All deliveries for that month were considered. Only deliveries that occurred between 28 and 42 weeks of pregnancy were considered. The association between risk variables was studied using multivariable logistic regression. Results There were 35,718 deliveries that occurred during these 15-year-study period in the gestational age 28-42 weeks were registered through the outpatient clinics. The incidence of LGA was 9.4 % that has mostly Lakshmanan Jeyaseelan is a Professor, Bijesh Yadav is a Senior Demonstrator, Veerasamy Silambarasan is a Research Fellow in the Department of Biostatistics, Reeta Vijayaselvi is a Assistant Professor, Ruby Jose is a Professor and Head in the Obstetrics and Gynaecology Unit IV, Christian Medical College, Vellore, India.Publishing datasets The dataset will not be available for publishing online since further research has been planned. remained at the same level. The incidence of LGA in mothers with gestational diabetes was 6.7, 3 and 17.6 % in overweight, obese and gestational l diabetes mothers. Overweight, obesity in pregnant women and cesarean section were significant risk factors. Conclusion Unlike in Western countries, where the incidence of LGA babies has spiraled upward, has remained nearly at the same level over one and a half decades, in South India. The risk factors for giving birth toLGA babies in South India were similar to other studies.

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“…The reported frequency of incontinence of stool in primiparous women ranges from 2 to 6% [MacArthur et al, 1997;Donnelly et al, 1998], and incontinence for either stool or £atus from 13 to 25% [Zetterstrom et al, 1999;Signorello et al, 2000]. After severe perineal laceration, the rate of anal incontinence rises to between 17 and 62% [Crawford et al, 1993;Sultan et al, 1993;Eason et al, 2002].…”

Section: Introductionmentioning

confidence: 99%

Asymmetric sphincter innervation is associated with fecal incontinence after anal sphincter trauma during childbirth

Wietek

Hinninghofen

Jehle

et al. 2006

Neurourology and Urodynamics

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Aims: Functional asymmetry of pelvic £oor innervation has been shown to exist in healthy subjects, and has been proposed to be a predictor of increased risk for fecal incontinence in case of trauma. However, this remains to be shown for di¡erent clinical conditions such as traumatic childbirth. Methods: A conventional surface EMG system was used to assess the innervation of the external anal sphincter. A symmetry index was used to de¢ne the relative EMG amplitude asymmetry of the external anal sphincter between 0 (symmetric) and 1 (asymmetric). Three cohorts were studied: 40 nulliparous women in the third trimester (Study 1), 15 primiparous women within 6 months following vaginal delivery without clinically apparent anal sphincter trauma (Study 2), and 50 women after childbirth-related third or fourth degree perineal tear 6^12 months postpartum (Study 3). Furthermore, all women underwent conventional anorectal manometry. Results: Sixteen or forty nulliparous women reported signs of fecal incontinence; however, relative asymmetry was not correlated to symptom severity (P ¼ 0.345), and not to manometric measures (Study 1). In Study 2, Women who had su¡ered clinically apparent anal sphincter trauma (P ¼ 0.07) tended to have a stronger association between incontinence and asymmetry. In Study 3, 19/50 women reported moderate to severe incontinence. Asymmetry and symptom severity were signi¢cantly correlated (P < 0.001). Patients with incontinence had a signi¢cantly higher asymmetry score than their continent counterparts. Conclusion: Functional asymmetry of anal sphincter innervation is signi¢cantly associated with incontinence symptoms, but only after childbirth-related sphincter injuries and therefore, should be regarded as an additional risk factor. Neurourol. Urodynam. 26: 134^139, 2007. ß 2006

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Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair

Cited by 179 publications

References 27 publications

The extent of endosonographic anal sphincter defects after primary repair of obstetric sphincter tears increases over time and is related to anal incontinence

The extent of endosonographic anal sphincter defects after primary repair of obstetric sphincter tears increases over time and is related to anal incontinence

Large for Gestational Age Births Among South Indian Women: Temporal Trend and Risk Factors from 1996 to 2010

Asymmetric sphincter innervation is associated with fecal incontinence after anal sphincter trauma during childbirth

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