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Fecal incontinence after high-risk delivery
Pauline Chiarelli1, Barbara Murphy, Jill Cockburn
1Discipline of Physiotherapy, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia. Pauline.Chiarelli@newcastle.edu.au
Obstetrics and Gynecology
|December 10, 2003
Summary
High-risk postpartum women face significant rates of fecal incontinence and precursor symptoms. Older age, multiparity, joint hypermobility, and concurrent urinary issues increase risk after difficult deliveries.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Maternal Health
Background:
- Postpartum fecal incontinence (FI) and its precursors affect women after high-risk deliveries.
- Understanding prevalence and risk factors is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of fecal incontinence and its precursor symptoms at 12 months postpartum.
- To identify factors associated with these conditions in high-risk women.
Main Methods:
- Survey of 568 high-risk postpartum women (instrumental delivery and/or high birth weight infant).
- Baseline hospital interview and 12-month follow-up telephone interview.
- Assessed frank FI (solid/liquid stool) and precursor symptoms (flatal incontinence, soiling, urgency).
Main Results:
- Frank FI prevalence: 2.6% (solid), 4.9% (liquid). Precursor symptoms: 24.4% (flatal incontinence), 10.9% (soiling), 14.8% (urgency).
- 32.4% experienced at least one precursor symptom; 6.9% had frank FI.
- Associated factors: concurrent urinary incontinence, postpartum constipation, joint hypermobility, older maternal age, inability to stop urine flow, multiparity.
Conclusions:
- Older, multiparous women, and those with joint hypermobility are at higher risk for postpartum anal incontinence.
- Urinary incontinence, impaired urinary flow control, and constipation are linked to postpartum anal incontinence symptoms following high-risk deliveries.