Does anal sphincter injury preclude subsequent vaginal delivery?

European Journal of Obstetrics, Gynecology, and Reproductive Biology
M FitzpatrickColm O'Herlihy

Abstract

To assess continence and anal sphincter integrity during a subsequent pregnancy and delivery in women known to have a previous anal sphincter injury. Prospective observational study. The National Maternity Hospital, Dublin, Ireland. Antenatal patients with a documented obstetric anal sphincter injury at a previous delivery. Women underwent symptom scoring, endoanal ultrasound and manometry. Recommended and actual mode of delivery, continence scores and endoanal ultrasound findings after index delivery. 557 women were studied. 293 (53%) had no symptoms of faecal incontinence, 189 (34%) had mild symptoms and 75 (13%) moderate or severe symptoms. 408 (73%) had an endoanal ultrasound. 383(94%) had a normal or small (<1 quadrant) defect in the internal anal sphincter and 390 (96%) had a scar or small (<1e quadrant) defect in the external anal sphincter. 393 (70%) delivered vaginally. 164 (30%) were delivered by caesarean section. 197/557 (35%) returned for follow-up. There was no significant change in continence following either vaginal or caesarean delivery. 20 (5.1%) women had a recognised second anal sphincter tear during vaginal delivery. The majority of women who sustain a third degree tear have minimal or no symptoms of faecal...Continue Reading

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Citations

Feb 17, 2017·American Journal of Obstetrics and Gynecology·Hanna JangöAbelone Sakse
Mar 24, 2017·International Urogynecology Journal·Judith J A E DonnersMirjam Weemhoff
Sep 20, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D SioutisA H Sultan
Apr 24, 2020·Female Pelvic Medicine & Reconstructive Surgery·Cecilia K WieslanderSarah A Collins
Jul 18, 2020·United European Gastroenterology Journal·Ferdinando D'AmicoLaurent Peyrin-Biroulet
Dec 28, 2016·International Urogynecology Journal·Sara S WebbKhaled M K Ismail
Dec 3, 2020·International Urogynecology Journal·Nicola Adanna OkeahialamAbdul H Sultan
Jan 6, 2021·International Urogynecology Journal·Aurore FehlmannMarie-Eve Clermont
Jan 18, 2021·Journal of Visceral Surgery·P ViannayA Venara
May 15, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Annika TaithongchaiAbdul H Sultan
Apr 15, 2019·American Journal of Obstetrics and Gynecology·Annika TaithongchaiRanee Thakar

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