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The effect of a normal vaginal delivery on anal function
N Rieger1, A Schloithe, G Saccone
1Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia.
Background:
To determine the effect of an uncomplicated vaginal delivery on anal sphincter function in primiparous women.
Methods:
In a prospective study, anal manometry was performed prenatally and at 4-6 weeks postnatally in 18 primiparous women (11 undergoing vaginal delivery; seven having Cesarean section). No patient had any evidence of anal sphincter damage after delivery as determined by anal ultrasound and pudendal nerve terminal motor latency.
Results:
Vaginal delivery was associated with a significant reduction in the squeeze pressure (SP: prenatal 269 cm H2O vs postnatal 204 cm H2O; p=0.004) but not the resting pressure (RP: prenatal 96 cm H2O vs postnatal 86 cm H2O; p=0.075). Cesarean section was not associated with any significant change in anal pressures.
Conclusion:
A normal vaginal delivery with no evidence of sphincter injury was associated with a significant effect on anal function when measured 4-6 weeks postnatally.