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Parity and anal sphincter trauma.

Yanping Li1,2, Ka Lai Shek3,4, Nishamini Subramaniam2

  • 1Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.

International Urogynecology Journal
|September 9, 2019
PubMed
Summary

Subsequent vaginal births do not increase the risk of external anal sphincter (EAS) tears. This study found no significant difference in EAS tear prevalence between women having their first or multiple vaginal births.

Keywords:
Anal incontinenceAnal sphincter traumaMaternal traumaParityTomographic ultrasound imagingTransperineal ultrasound

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Area of Science:

  • Urogynecology
  • Maternal Health
  • Diagnostic Imaging

Background:

  • Obstetric anal sphincter injury (OASI) is a significant maternal trauma from vaginal birth.
  • Women with a history of OASI face higher recurrence risks.
  • The impact of multiparity on OASI prevalence remains unclear.

Purpose of the Study:

  • To investigate the relationship between vaginal parity and the prevalence of external anal sphincter (EAS) tears.
  • To test the hypothesis that multiparity is associated with a higher prevalence of EAS tears diagnosed via transperineal ultrasound (TPUS).

Main Methods:

  • Retrospective observational study of 1,273 women attending a tertiary urogynecology service.
  • Standardized interviews, clinical examinations, and 4D transperineal ultrasound (TPUS) were performed.
  • External anal sphincter (EAS) evaluation using tomographic ultrasound imaging, blinded to clinical data.

Main Results:

  • 1,143 women (90%) were vaginally parous, with a mean parity of 2.
  • External anal sphincter (EAS) defects were identified in 148 women (12%) via ultrasound.
  • No significant difference in EAS defect prevalence was found between primiparous and multiparous women (p=0.460).

Conclusions:

  • The prevalence of external anal sphincter (EAS) tears does not differ significantly between women with single or multiple vaginal births.
  • Findings suggest subsequent vaginal births may not exert additional traumatic effects on the anal sphincter.