Incidence and risk factors of postpartum anal incontinence a prospective study of 503 cases.

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Published Apr 3, 2014
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Vol. 92 No. 2 (2014): Issue Feb 2014

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Monia Malek-mellouli
Soulé Assen
Fethi Ben Amara
Hamdi Gada
Kacem Masmoudi
Hédi Reziga

Abstract

Background: Background: Anal incontinence is a devastating functional postpartum complication. it can cause deep deterioration in the quality of life.
aim : To assess the incidence of postpartum anal incontinence (PPAI) and the major risk factors predisposing for it in the short and middle terms.
methods: This prospective observational study was conducted in the department of Obstetrics and Gynecology B in the Maternity and Neonatology Center of Tunis between March 1st and july 31st, 2009.
results: Five hundred and three women were included. PPAI was 4.2% on the fourth day postpartum and 4% between weeks 6 and 8 postpartum. Predisposing factors to 4th day PPAI were forceps delivery (p<0.001), prolonged second stage of labor> 5hours (p=0.047), expulsion phase > 20mn (p<0.001), uterine revision (P=0.001) and first degree perineal lacerations (p<0.001). Between 6 and 8 weeks postpartum, identified risk factors were Shoulder dystocia (p<0.001), anu-vulvar distance <2cm, perineal scars and transverse abdominal diameter >105mm (p<0.001).
Conclusion: Preventive measures must be implemented in patients with PPAI risk factors.

Keywords:

Fecal incontinence; Delivery; postpartum

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