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Related Experiment Videos

Do routinely measured delivery variables predict anal sphincter outcome?

A Varma1, J Gunn, S W Lindow

  • 1Academic Surgical Unit, Castle Hill Hospital, Cottingham, East Yorkshire, United Kingdom.

Diseases of the Colon and Rectum
|October 21, 1999
PubMed
Summary

Forceps delivery significantly increases the risk of anal sphincter trauma. Routine postnatal anorectal assessment is recommended for instrument deliveries, not normal vaginal births.

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Area of Science:

  • Obstetrics and Gynecology
  • Pelvic Floor Disorders
  • Surgical Complications

Background:

  • Anal sphincter trauma is a known complication of childbirth, potentially worsening with subsequent deliveries.
  • Predicting anal sphincter damage is crucial for targeted interventions during labor.
  • Previous research on delivery variables linked to sphincter damage remains inconclusive.

Purpose of the Study:

  • To investigate the correlation between routinely recorded obstetric variables and anal sphincter damage.
  • To identify predictive factors for anal sphincter trauma in a series of female patients.

Main Methods:

  • A prospective study conducted in a single maternity unit.
  • Patients assessed pre-discharge using symptom questionnaires and endoanal ultrasound.

Related Experiment Videos

  • Delivery data collected prospectively and analyzed for significant associations with sphincter defects.

    • Main Results:

    • Endosonography revealed sphincter injuries in 8.7% of normal vaginal deliveries versus 83% of forceps deliveries.
    • No significant correlation found between sphincter trauma and head circumference, birth weight, maternal BMI, epidurals, episiotomy, labor duration, or pushing duration.
    • Forceps delivery emerged as the sole significant predictor of anal sphincter trauma.

    Conclusions:

    • Commonly measured delivery variables, excluding forceps use, are not reliable predictors of anal sphincter trauma.
    • Routine postnatal anorectal assessment is not necessary after normal vaginal deliveries.
    • Postnatal anorectal assessment should be standard practice for all patients undergoing instrument-assisted deliveries.