Results of surgical treatment of anal sphincter injury following vaginal delivery at Hanoi Medical University Hospital: a case series report

2021 ◽  
Vol 148 (12) ◽  
pp. 146-151
Author(s):  
Tran Ngoc Dung ◽  
Tran Bao Long ◽  
Luu Quang Dung ◽  
Nguyen Thi Thu Vinh ◽  
Nguyen Duc Phan
Keyword(s):  
Fecal Incontinence ◽  
Vaginal Delivery ◽  
Case Series ◽  
University Hospital ◽  
Sphincter Injury ◽  
Incontinence Score ◽  
Anal Sphincter Injury ◽  
Functional Anal ◽  
Case Series Report ◽  
Technique Evaluation

The repair of sphincter injury following vaginal delivery is often inadequate or the injury was undetected. The consequence is fecal incontinence. In this descriptive study, five patients underwent sphincter repair by the “overlap” technique. Evaluation of postoperative outcomes at 3 and 12 months showed that the Wexner fecal incontinence score at 17 - 20 score decreased to 0 - 6 score. Transperineal ultrasound showed that all five patients healed well. Measurement of anal manometry, functional anal canal length, resting anal pressures and squeezing anal pressures was better after surgery.

scholarly journals Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Marta Simó González ◽  
Oriol Porta Roda ◽  
Josep Perelló Capó ◽  
Ignasi Gich Saladich ◽  
Joaquim Calaf Alsina
Keyword(s):  
Risk Factor ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
University Hospital ◽  
Obstetric Anal Sphincter Injury ◽  
Vacuum Extraction ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Vaginal Deliveries ◽  
Spontaneous Delivery

The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case.

scholarly journals Risk Factors and Outcome of Patients with Obstetric Anal Sphincter Injuries (OASIS)

2018 ◽  
Vol 1 (2) ◽  
pp. 69-72
Author(s):  
Rabindra D. Bhatt ◽  
S. Sitaula ◽  
T. Pradhan ◽  
T. Manandhar ◽  
T. Basnet
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Fecal Incontinence ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injuries ◽  
Sphincter Injury ◽  
Second Stage Of Labor ◽  
Anal Sphincter Injury ◽  
Operative Vaginal Delivery

Background: Anal incontinence is an embarrassing condition that is largely underreported. Obstetric anal sphincter injuries are the most important etiological factors. Anal sphincter injury during delivery is considered to be one of the major risk factors for fecal incontinence in women. After anal sphincter injury at the time of delivery, up to 50% women have complaints of fecal incontinence, mainly because of persisting sphincter defects. Objectives: To evaluate the risk factors for the occurrence of obstetric anal sphincter injuries during vaginal delivery. To evaluate the outcome of patients with obstetric anal sphincter injuries. Methodology: A retrospective descriptive study was conducted from 2014 to 2016. Data of all patients with Obstetric Anal Sphincter Injuries (OASIS) over 3 years was collected from the medical record section after ethical clearance from Institutional Review Committee (IRC), BPKIHS. The data was entered in the excel sheet and analyzed using SPSS 17. Results: The Most important risk factor of OASIS was operative vaginal delivery (vacuum assisted vaginal delivery), followed by birth weight of the baby greater than 3.5 Kg and primigravida. Conclusion: Patients undergoing operative vaginal delivery, primigravida and birth weight greater than 3 kg are the important risk factors for OASIS. So, patients with these conditions should be handled carefully during second stage of labor to prevent the occurrence of OASIS.

scholarly journals A rare off-site aperture of the anal canal following an obstetric anal sphincter trauma.

2021 ◽  
Author(s):  
Sofoklis Stavros ◽  
Ioannis Papapanagiotou ◽  
Dimitris Zacharakis ◽  
Kyriaki Migklis ◽  
Rafail Mantzioros ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Anal Canal ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injury ◽  
Common Complication ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Perineal Injuries ◽  
Anal Sphincter Trauma

Obstetric anal sphincter injury is a common complication of vaginal delivery. Such injuries are more likely to result in postpartum fecal incontinence and thus diagnosis and restoration of perineal injuries at the time of vaginal delivery is of paramount importance.

scholarly journals Anal sphincteric neurogenic injury in asymptomatic nulliparous women and fecal incontinence

2012 ◽  
Vol 303 (2) ◽  
pp. G256-G262 ◽  
Author(s):  
Adil E. Bharucha ◽  
Jasper Daube ◽  
William Litchy ◽  
Julia Traue ◽  
Jessica Edge ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Muscle Injury ◽  
Normal Values ◽  
Substantial Agreement ◽  
Sphincter Injury ◽  
Squeeze Pressure ◽  
Anal Sphincter Injury ◽  
Nulliparous Women ◽  
Κ Statistic

While anal sphincter neurogenic injury documented by needle electromyography (EMG) has been implicated to cause fecal incontinence (FI), most studies have been uncontrolled. Normal values and the effects of age on anal sphincter motor unit potentials (MUP) are ill defined. The functional significance of anal sphincter neurogenic injury in FI is unclear. Anal pressures and EMG were assessed in 20 asymptomatic nulliparous women (age, 38 ± 5 yr; mean ± SE) and 20 women with FI (54 ± 3 yr). A computerized program quantified MUP duration and phases. These parameters and MUP recruitment were also semiquantitatively assessed by experienced electromyographers in real time. Increasing age was associated with longer and more polyphasic MUP in nulliparous women by quantitative analysis. A higher proportion of FI patients had prolonged (1 control, 7 patients, P = 0.04) and polyphasic MUP (2 controls, 9 patients, P = 0.03) at rest but not during squeeze. Semiquantitative analyses identified neurogenic or muscle injury in the anal sphincter (11 patients) and other lumbosacral muscles (4 patients). There was substantial agreement between quantitative and semiquantitative analyses (κ statistic 0.63 ± 95% CI: 0.32–0.96). Anal resting and squeeze pressures were lower ( P ≤ 0.01) in FI than controls. Anal sphincter neurogenic or muscle injury assessed by needle EMG was associated ( P = 0.01) with weaker squeeze pressures (83 ± 10 mmHg vs. 154 ± 30 mmHg) and explained 19% ( P = 0.01) of the variation in squeeze pressure. Anal sphincter MUP are longer and more polyphasic in older than younger nulliparous women. Women with FI have more severe neurogenic or muscle anal sphincter injury, which is associated with lower squeeze pressures.

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