Obstetric anal sphincter injury
نویسنده
چکیده
Obstetric trauma following childbirth is the primary cause of faecal incontinence in women. Injury to the anal sphincter complex is common: it has been clinically diagnosed in 0.4–2.5% of vaginal deliveries involving a mediolateral episiotomy and in up to 19% of cases of midline episiotomy. Studies using endoanal ultrasound have reported occult anal sphincter injury in up to 35% of women after their first delivery. This paper reviews the risk factors for obstetric anal sphincter injury, as well as diagnosis and management of the condition.
منابع مشابه
Recurrent obstetric anal sphincter injury and the risk of long-term anal incontinence.
BACKGROUND Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. OBJECTIVE The objective of the study was to evaluate whether recurr...
متن کاملMode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury
The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal d...
متن کاملObstetric anal sphincter injury.
Anal sphincter injury during childbirth is a leading cause of anal incontinence. In a study of more than 20 000 consecutive vaginal deliveries, clinically diagnosed obstetric anal sphincter injury occurred in 2.9% of primiparous women and 0.8% of multiparous ones. Of women who have sustained such an injury, 60-80% are asymptomatic at 12 months, of whom most report incontinence of flatus only, r...
متن کاملObstetric anal sphincter injury: how to avoid, how to repair: a literature review.
Avoiding obstetrical injury to the anal sphincter is the single biggest factor in preventing anal incontinence among women. Any form of instrument delivery has consistently been noted to increase the risk of obstetric anal sphincter injury and altered fecal continence by between 2- and 7-fold. Routine episiotomy is not recommended. Episiotomy use should be restricted to situations where it dire...
متن کاملRisk factors for and management of obstetric anal sphincter injury
Obstetric anal sphincter injury is the leading cause of faecal incontinence in women. Concerns have been expressed that some sphincter injuries are missed at the time of vaginal childbirth. There has also been a steady increase in the number of medico-legal cases associated with obstetric sphincter injury. Accurate diagnosis of third and fourth degree tears at the time of childbirth followed by...
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