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Effect of pregnancy on anal sphincter morphology and function
A H Sultan1, M A Kamm, C N Hudson
1St. Mark's Hospital, London, UK.
International Journal of Colorectal Disease
|December 1, 1993
Summary
Pregnancy does not significantly alter anal sphincter function or morphology. Studies show no changes in muscle thickness or pressure, suggesting mechanical trauma, not hormones, causes delivery-related sphincter issues.
Area of Science:
- Obstetrics and Gynecology
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Pregnancy and childbirth can lead to pelvic floor dysfunction.
- The specific impact of pregnancy on anal sphincter morphology and function requires further elucidation.
Purpose of the Study:
- To prospectively investigate the effects of pregnancy on the function and morphology of anal sphincters.
- To differentiate between pregnancy-induced and delivery-induced changes in anal sphincter parameters.
Main Methods:
- Prospective investigation of twenty pregnant women.
- Anal endosonography and manometry performed during pregnancy and postpartum (6 weeks after Cesarean section).
- Measurement of muscle thickness (puborectalis, longitudinal muscle, internal and external anal sphincter) and anal pressures (maximum resting and squeeze).
Main Results:
- No significant differences were observed in the muscle thickness of the puborectalis, longitudinal muscle, internal, or external anal sphincter before and after Cesarean delivery.
- Maximum resting pressure and maximum squeeze pressure remained unchanged.
- No significant correlation was found between anal pressure and sphincter muscle thickness.
Conclusions:
- Pregnancy itself does not exert a significant effect on the morphology or function of the anal sphincters.
- Observed changes in sphincter function related to pregnancy or delivery are more likely attributable to mechanical trauma than hormonal influences during pregnancy.