Document Detail


Does cesarean delivery prevent anal incontinence?
MedLine Citation:
PMID:  12576254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the incidence and severity of anal incontinence in primiparas after cesarean delivery versus spontaneous vaginal delivery. METHODS: A total of 184 primiparas who delivered by cesarean (104 emergency, 80 elective) and 100 who delivered vaginally were interviewed 10 +/- 2 months postpartum. A comprehensive bowel function questionnaire was completed. Bowel-specific questions included bowel habits, laxative use, urgency, flatus, urge and passive incontinence, soiling, and pad use, before and during pregnancy and postpartum. Obstetric details were confirmed from obstetric records. RESULTS: Anal incontinence was first present in nine (5%) mothers after cesarean delivery and eight (8%) after vaginal delivery (relative risk 0.611, 95% confidence interval 0.25, 1.53). Severe symptoms necessitating pad use affected two (3%) mothers after elective cesarean and one (1%) after vaginal delivery. Two (3%) mothers after elective cesarean, one (1%) after emergency cesarean, and two (2%) after vaginal delivery had at least two symptoms. Anal incontinence followed prelabor emergency cesarean in two mothers. Of the 22 mothers who sustained a second-degree tear, five (23%) had new anal incontinence compared with only one (3%) of 40 mothers with an intact perineum (Fisher exact test value = 9.697, P =.014). CONCLUSION: Because severe anal incontinence followed elective and prelabor emergency cesarean, it seems that pregnancy itself can lead to pelvic floor disorders. A high incidence of anal incontinence is associated with a second-degree tear. Measures to detect and reduce postpartum anal incontinence should target all pregnant women and mothers, even after prelabor cesarean delivery.
Authors:
Mira Lal; Christopher H Mann; Roger Callender; Simon Radley
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  101     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-10     Completed Date:  2003-03-12     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Wordsley Hospital, Dudley Group of Hospitals, National Health Service Trust, Stourbridge, West Midlands, United Kingdom. mira@miralal.freeserve.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cesarean Section / methods*
Confidence Intervals
Delivery, Obstetric / methods
Fecal Incontinence / diagnosis,  epidemiology*,  prevention & control*
Female
Follow-Up Studies
Humans
Incidence
Natural Childbirth
Obstetric Labor Complications / prevention & control*
Parity
Perineum / injuries
Pregnancy
Probability
Reference Values
Risk Factors
Sampling Studies
Sensitivity and Specificity
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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