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Faecal incontinence after first instrumental vaginal delivery using Thierry's spatulas
Olivier Parant1, Caroline Simon-Toulza, Christelle Cristini
1CHU de Toulouse, Service de gynécologie obstétrique, Hôpital Paule de Viguier, 330 avenue de Grande-Bretagne, 31059, Toulouse, France. olivier.parant@wanadoo.fr
Objective:
The purpose of this study is to estimate the prevalence of faecal incontinence after first vaginal delivery and to assess the impact of Thierry's spatulas-assisted delivery.
Methods:
A prospective observational study of primiparas who underwent a vaginal delivery at term was conducted. Faecal incontinence was assessed at 2 and 6 months postpartum by a questionnaire (Wexner score >or=5 was considered significant). Univariate and multivariate analyses were performed.
Results:
Five hundred thirty-eight women were recruited with undergoing 176 spatulas-assisted deliveries and 362 spontaneous vaginal deliveries. The response rate was 85.9% (2 months) and 80.5% (6 months). The prevalence of faecal incontinence was similar between the two groups at 2 months (14.3% and 9.7%). Episiotomy (odds ratio [OR] = 5.0) and maternal age over 35 years (OR = 4.1) were independently associated with faecal incontinence after adjustment.
Conclusions:
Anal symptoms are common after the first vaginal delivery. Thierry's spatulas do not increase the prevalence of faecal incontinence after delivery given that an episiotomy is performed.
