Mode of delivery after previous obstetric anal sphincter injuries (OASIS)--a reappraisal?

Inka Scheer, Ranee Thakar, Abdul H Sultan
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引用次数: 82

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.

以前产科肛门括约肌损伤(OASIS)后的分娩方式——重新评估?
前言和假设:前瞻性评估既往产科肛门括约肌损伤(OASIS)后分娩后肛门直肠症状、生活质量(QoL)、括约肌完整性和功能。方法:采用经验证的曼彻斯特健康问卷,在妊娠晚期和产后13周进行肛门超声检查和测压。没有客观损害肛门功能的妇女建议阴道分娩,其他妇女建议剖腹产。结果:73名连续出现过OASIS的妇女在随后的妊娠中被观察到,其中59名在分娩后13周被复查。在随后的阴道分娩或剖宫产后,肛门测压结果没有明显变化。只有一个新的缺陷(内括约肌)发生在阴道分娩后。症状或生活质量没有明显变化。3例(6.8%)持续重复OASIS。结论:没有产前证据表明肛门括约肌功能客观损害的妇女可以放心,阴道分娩与任何显着的功能或生活质量恶化无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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