Using the Brink score to predict postpartum anal incontinence

King, Virginia G.; Boyles, Sarah Hamilton; Worstell, Teresa; Zia, Joy; Clark, Amanda; Gregory, W. Thomas

doi:10.1016/j.ajog.2010.07.032

Cited by 17 publications

(20 citation statements)

References 26 publications

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“…7 these studies report that 3% to 14% of patients experience fi. 5,6 there is scarce information in this area, but interestingly the theories are focused on urinary incontinence. 21 the large increase in stress and urge incontinence in early pregnancy is consistent with alterations in collagen as the cause of this clinical problem.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Fecal Incontinence in Women During Pregnancy

Parés

Franco

Lorente

et al. 2015

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 99%

Prevalence of Fecal Incontinence in Women During Pregnancy

Parés

Franco

Lorente

et al. 2015

Diseases of the Colon &Amp; Rectum

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“…Urinary incontinence (UI) commonly occurs during pregnancy, affecting 26-70% of women (1-8). Anal incontinence, while less common, troubles 1.3-16% of women during pregnancy and may be a source of embarrassment (1-3, 9-11). Many women experience a decline in sexual activity and function while pregnant.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor symptoms and quality of life changes during first pregnancy: a prospective cohort study

et al. 2017

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Introduction We describe pelvic floor function in nulliparous pregnant women. Materials/Methods Nulliparous midwifery patients completed the Incontinence Severity Index (ISI), Pelvic Floor Impact Questionnaire (PFIQ-7), Wexner Fecal Incontinence Scale (W), and answered questions about sexual activity and perineal pain at baseline during the first (T1), second (T2), or third trimester (T3) and repeated in late T3. They also underwent a Pelvic Organ Prolapse Quantification (POPQ) exam at their baseline visit. Data were compared across trimesters. ANOVA and logistic regression accounted for repeated measures and was controlled for age and education. Results We recruited 627 women. In T1, 124 women gave baseline data and completed questionnaires, 403 in T2, and 96 in early T3 (496 repeated questionnaires in later T3). Besides an increase in genital hiatus and perineal body (all adjusted p < .05), physical exam measures did not differ between trimesters. As pregnancy progressed, urinary incontinence (UI) (T1=33, T2=44, T3=69% women with ISI >0, all comparisons p<.02) and IIQ-7 scores increased. Fecal incontinence (FI) increased (T1=8, T2=15, T3=16% from T2 to T3, p=.04), while CRAIQ-7 scores did not increase. Perineal pain increased (T1=17, T2=18 and T3 = 40%, all adjusted p <.001), and sexual activity decreased as pregnancy progressed (T1= 94, T2 = 90, T3 = 77% sexually active, T1 vs T3 and T2 vs T3, p <.001). Conclusions During pregnancy, women experience worsening UI, FI and perineal pain. UI symptoms are associated with a negative impact on quality of life. Sexual activity decreases and POPQ stage does not change.

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“…[7][8][9] Several authors suggest that pregnancy-related changes to the pelvic floor muscles' neuromuscular function is of greater importance than changes or injuries occurring during delivery; however, faecal urgency has been shown to be less prevalent among women with caesarean section than with vaginal deliveries. [10][11][12][13][14][15] Previous findings indicate that nearly 30-50% of pregnant women experience AI in late pregnancy; however, the prevalence of AI is markedly reduced 6-12 months after delivery. 10,13,16,17 Due to the complexity of maintaining continence, it is suggested that the individual perception and experience of AI may contribute more to the impact on QoL than the objective severity of AI.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13][14][15] Previous findings indicate that nearly 30-50% of pregnant women experience AI in late pregnancy; however, the prevalence of AI is markedly reduced 6-12 months after delivery. 10,13,16,17 Due to the complexity of maintaining continence, it is suggested that the individual perception and experience of AI may contribute more to the impact on QoL than the objective severity of AI. Hence obtaining measures of conditionspecific Health Related QoL as well as the severity of a patient's incontinence problems is recommended.…”

Section: Introductionmentioning

confidence: 99%

Anal incontinence and Quality of Life in late pregnancy: a cross‐sectional study

Johannessen

Mørkved

Stordahl

et al. 2014

BJOG

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Objective To evaluate the association between different types of anal incontinence (AI) and Quality of Life (QoL) in late pregnancy.Design Cross-sectional study.Setting Two maternity units in Norway 2009-2010.Population Primiparae aged 18 or over.Methods Participants answered questions about AI during the last 4 weeks of pregnancy on the St. Mark's score and impact of QoL in the Fecal Incontinence QoL score. Socioeconomic data were obtained from hospital records.Main outcome measures Self-reported AI and impact on QoL.Results 1571 primiparae responded; 573 (37%) had experienced AI during the last 4 weeks of pregnancy. One third of the incontinent women reported reduced QoL in the domain 'Coping'. 'Women experiencing urgency alone reported markedly better QoL compared to any other AI symptoms. AI appeared to have the strongest impact on the domains 'Coping' and 'Embarrassment'. Depression was only associated with experiencing the combination of all three symptoms [odds ratio (OR) 13; 95%confidence interval (CI) 3.2-51]. Experiencing flatus alone weekly or more was associated with the highest impact on 'Embarrassment' (OR 20; 95%CI 6.4-61) compared with all other symptoms or combination of AI symptoms, except the combination of all three AI symptoms.Conclusions Between 3 and 10% of the primiparae in this material experienced AI to such a extent that it affected QoL. The greatest impact was seen in the QoL domain 'Coping'. These findings highlight the importance of an increased awareness of AI in late pregnancy among health professionals and the need to implement routine discussions about AI with expectant and new mothers.

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Using the Brink score to predict postpartum anal incontinence

Cited by 17 publications

References 26 publications

Prevalence of Fecal Incontinence in Women During Pregnancy

Prevalence of Fecal Incontinence in Women During Pregnancy

Pelvic floor symptoms and quality of life changes during first pregnancy: a prospective cohort study

Anal incontinence and Quality of Life in late pregnancy: a cross‐sectional study

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