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Disturbed anal sphincter function following vaginal delivery

J M Wynne1, J L Myles, I Jones

  • 1University Department of Obstetrics and Gynaecology, Mater Hospital, South Brisbane, Australia.

Gut
|July 1, 1996
PubMed
Summary
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The first vaginal delivery permanently lowers resting anal pressures. This study evaluated the impact of childbirth on internal sphincter function, finding lasting effects even after recovery periods.

Area of Science:

  • Obstetrics and Gynecology
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Idiopathic fecal incontinence research has shifted focus to the internal anal sphincter.
  • Understanding the impact of childbirth on anal sphincter function is crucial.

Purpose of the Study:

  • To investigate the effects of vaginal delivery on internal anal sphincter pressures.
  • To assess long-term changes in sphincter function following childbirth.

Main Methods:

  • Sphincter pressures were measured in 1202 mothers antenatally and postnatally.
  • Follow-up measurements were taken six to 10 weeks after delivery in selected patients.

Main Results:

  • Vaginal deliveries, particularly the first, significantly lowered resting anal pressures compared to antenatal values.

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  • Primiparous women and those with spontaneous vaginal deliveries showed reduced pressures.
  • While some recovery occurred, pressures remained lower six to 10 weeks postpartum.

    • Conclusions:

    • The first vaginal delivery results in a permanent reduction in resting anal pressures.
    • Childbirth is a significant factor in altered internal sphincter function.
    • Further research is needed to explore the mechanisms behind this persistent pressure reduction.