Abstract
Introduction and hypothesis
To prospectively evaluate anorectal symptoms, quality of life (QoL), sphincter integrity and function after subsequent childbirth following previous obstetric anal sphincter injuries (OASIS).
Methods
A validated Manchester Health Questionnaire, endoanal sonography and manometry were performed during the third trimester and 13 weeks postpartum. Women without objective compromise of anal function were recommended a vaginal delivery and the others a caesarean section.
Results
Seventy-three consecutive women with previous OASIS were seen during a subsequent pregnancy of whom 59 were reviewed 13 weeks following delivery. Anal manometry findings did not change significantly following a subsequent vaginal delivery or caesarean section. Only one new defect (internal sphincter) occurred after a vaginal delivery. There was no significant change in symptoms or QoL. Three (6.8%) sustained repeat OASIS.
Conclusions
Women who have no antenatal evidence of objective compromise of anal sphincter function can be reassured that a vaginal delivery is not associated with any significant deterioration in function or QoL.
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Acknowledgement
I. Scheer was funded by a grant from the Mayday Childbirth Trust.
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Scheer, I., Thakar, R. & Sultan, A.H. Mode of delivery after previous obstetric anal sphincter injuries (OASIS)—a reappraisal?. Int Urogynecol J 20, 1095–1101 (2009). https://doi.org/10.1007/s00192-009-0908-8
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DOI: https://doi.org/10.1007/s00192-009-0908-8