Long-term ailments due to anal sphincter rupture caused by delivery--a hidden problem

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 27; no. 1; p. 27
• Main Authors: Haadem, K, Ohrlander, S, Lingman, G
• Format: Journal Article
• Language: English
• Published: Ireland 01-01-1988
• Subjects: Adult; Anal Canal - injuries; Delivery, Obstetric - adverse effects; Female; Humans; Pregnancy; Retrospective Studies; Rupture
• ISSN: 0301-2115
• DOI: 10.1016/S0028-2243(88)80007-8

Questionnaires concerning ailments were sent postpartum (mean two years) to 62 women with anal sphincter ruptures (ASR), who were compared with a matched control population. The frequency of anal sphincter rupture at the hospital during delivery in the period, 1978-82, was 0.7% (n = 63). Primiparity, instrumental deliveries, abnormal presentation, large babies and oxytocin stimulation were all risk factors. Of 59 women answering the questionnaire 37 (63%) stated that they had had ailments three months postpartum, mainly with pain and involuntary passage of flatus but also with dyspareunia and occasional incontinence of faeces. Long-term symptoms were noted by 28 (48%) of the women, mainly with involuntary passage of flatus but also perineal pain, dyspareunia and occasional incontinence of faeces. Long-term symptoms occurred in 7 (88%) of women with ASR also involving the anal mucosa, but only in 21 (39%) of those with ASR only. Three of the patients subsequently underwent reconstructive surgery, and three complained of psychological problems.