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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
International Urogynecology Journal
|May 14, 2010
Summary
Faecal incontinence is common after a first vaginal delivery. Thierry's spatulas did not increase its prevalence, but episiotomy and maternal age over 35 were risk factors.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Women's Health
Background:
- Anal symptoms, including faecal incontinence, can occur after childbirth.
- Understanding the prevalence and risk factors for postpartum faecal incontinence is crucial for maternal care.
Purpose of the Study:
- To determine the incidence of faecal incontinence following a woman's first vaginal delivery.
- To evaluate the effect of Thierry's spatulas-assisted delivery on the occurrence of faecal incontinence.
Main Methods:
- A prospective observational study included primiparas undergoing vaginal delivery.
- Faecal incontinence was assessed using the Wexner score at 2 and 6 months postpartum.
- Statistical analyses included univariate and multivariate models.
Main Results:
- 538 women were studied, with 176 assisted by spatulas and 362 by spontaneous delivery.
- Faecal incontinence prevalence was comparable between groups at 2 months (14.3% vs. 9.7%).
- Episiotomy (OR=5.0) and maternal age >35 (OR=4.1) were independent risk factors.
Conclusions:
- Postpartum anal symptoms are frequent after initial vaginal births.
- Thierry's spatulas do not elevate faecal incontinence risk when an episiotomy is performed.
- Identifying risk factors like episiotomy and advanced maternal age is key for prevention strategies.
