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Perineal rupture following vaginal delivery. Long-term consequences
S Mellerup Sørensen1, H Bondesen, O Istre
1Department of Gynecology and Obstetrics, Holstebro Central Hospital, Denmark.
Acta Obstetricia Et Gynecologica Scandinavica
|January 1, 1988
Summary
Complete perineal rupture in women can lead to long-term anal incontinence and reduced sphincter strength. This study highlights the significant sequelae following such obstetric trauma.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Surgical Sequelae
Background:
- Complete perineal rupture is a severe obstetric injury.
- Long-term consequences of perineal damage are not fully understood.
- Risk factors and sequelae require further investigation.
Purpose of the Study:
- To compare women with complete perineal rupture to a control group.
- To identify risk factors associated with perineal rupture.
- To assess long-term sequelae, including anal incontinence and anal sphincter function.
Main Methods:
- A case-control study comparing 25 women with complete perineal rupture to 25 controls.
- Follow-up included questionnaires and clinical assessments (perineal inspection, anal pressure profile).
- Average follow-up period was 78 months.
Main Results:
- Vacuum extraction was more frequent in the rupture group (p<0.002).
- 80% of rupture cases were primiparae vs. 40% in controls (p<0.02).
- 42% of rupture group reported anal incontinence vs. 0% in controls (p<0.01), primarily stress-related.
- Reduced anal sphincter pressure and length were observed in the rupture group.
Conclusions:
- Complete perineal rupture is associated with significant long-term anal incontinence.
- Reduced anal sphincter strength and length are common sequelae.
- Obstetric management and long-term follow-up are crucial for women with perineal rupture.