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Acta Obstet Gynecol Scand. 2011 Mar;90(3):258-63. doi: 10.1111/j.1600-0412.2010.01037.x. Epub 2010 Dec 14.

Complete rupture of anal sphincter in primiparas: long-term effects and subsequent delivery.

Author information

1
Södersjukhuset, Division of Obstetrics and Gynecology, Stockholm, Sweden. gisela.wegnelius@sodersjukhuset.se

Abstract

OBJECTIVE:

To study long-term effects with respect to anal incontinence, pain, attitude to and mode of second delivery following complete rupture of the anal sphincter.

DESIGN:

Case-control study. Settings. Södersjukhuset, a university hospital in Stockholm.

POPULATION:

A case group of 136 primiparas who had experienced a complete rupture of the anal sphincter. Two matched control groups of primiparas, one of whom had cesarean section and the other a normal vaginal delivery.

METHODS:

The case women were examined and asked for symptoms of anal incontinence 3-6 months after delivery; 3-8 years later they and two matched control groups answered a postal questionnaire. Response rate was 89%.

MAIN OUTCOME MEASURES:

Symptoms of pelvic floor dysfunction and, as secondary end-point, the attitude to and mode of second delivery.

RESULTS:

Anal incontinence after delivery was reported by 31% in the case group, and at long-term follow-up by 54% in the case group, 21% in the cesarean section and 23% in the normal delivery group (p < 0.0001). A wish to postpone or abandon further childbirth was significantly more common in the case women (33 and 18%) than in the other groups, but about 60% delivered again in all groups. In the case group, the next delivery was by cesarean section in 49%.

CONCLUSION:

At long-term follow-up after a complete rupture of the anal sphincter, anal incontinence was common and many women wished to postpone or avoid further delivery.

[Indexed for MEDLINE]

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