Archive \ Volume.13 2022 Issue 1

Surgical Treatment Results in Obstetric and Iatrogenic Anal Sphincter Injuries

Mehmet Burak Dal
Abstract

One of the most important causes of perineal tears is vaginal delivery or episiotomy. It is also among the iatrogenic causes. Perineal tears have the advantage that they can be effectively corrected by surgical repair. However, if perineal tears occurring upon delivery are not recognized and repaired immediately, the possibility of developing fecal incontinence and other complications increases. Since the aim of our study was to examine the surgical treatment of obstetric perineal tears, the files of patients who underwent anal sphincter repair between January 1, 2017, and January 1, 2019, were reviewed retrospectively. The files of 26 patients were analyzed in the present study. Sixteen patients were due to obstetric injuries; fourteen (70%) patients in the first 24 hours, and 6 (30%) occurred later. The data of the group repaired in the first 24 hours (early group) and the group repaired later was analyzed; there was no significant difference in terms of mean age, the number of births, and episiotomy opening (p>0.05674). However, there was a significant difference in the hospital stay (p<0.05). Obstetric anal sphincter injuries affect about half of women who have a vaginal delivery, and incontinence develops in 25% of primiparous patients with these injuries. The opinion of an experienced second physician is required. Effective sphincter repairs applied in this way can prevent long-term complications such as anal incontinence.



How to cite:
Vancouver
Dal M B. Surgical Treatment Results in Obstetric and Iatrogenic Anal Sphincter Injuries. Arch. Pharm. Pract. 2022;13(1):58-60. https://doi.org/10.51847/2IkoQrhZDJ
APA
Dal, M. B. (2022). Surgical Treatment Results in Obstetric and Iatrogenic Anal Sphincter Injuries. Archives Of Pharmacy Practice, 13(1),58-60. https://doi.org/10.51847/2IkoQrhZDJ

Download Citation
References

1.        Patmano M, Çetin DA, Gümüş T, Yavuz Y, Yıldırım S. Episiotomy-Related Perineal Injury During Spontaneous Vaginal Delivery. Turk J Colorectal Dis. 2018;28(2):95-8. doi:10.4274/tjcd.79847

2.        Nikbakht R, Hemadi M. Transvaginal cervical length and Bishop score value in predicting successful labor induction with an emphasis on the parity. Int J Pharm Res Allied Sci. 2016;5(2):114-8.

3.        Mirzaei R, Kheirkhah M, Inanlou M, Haghani S. Effect of group couseling on mental health of women with unsuccessful pregnancy. J Adv Pharm Educ Res. 2021;11(2):124-31. doi:10.51847/s5u1VfrbHU

4.        Gerli S, Favilli A, Affronti G, Acanfora M, Sabatini A, Floridi C, et al. Prophylactic arterial catheterization in the management of high risk patients for obstetric haemorrhage. Eur Rev Med Pharmacol Sci. 2013;17(20):2822-6.

5.        Glazener CM, Herbison GP, MacArthur C, Grant A, Wilson PD. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow-up. BMJ. 2005;330(7487):337. doi:10.1136/bmj.38320.613461.82

6.        Frohlich J, Kettle C. Perineal care. BMJ Clin Evid. 2015:2015.

7.        Stock L, Basham E, Gossett DR, Lewicky-Gaupp C. Factors associated with wound complications in women with obstetric anal sphincter injuries (OASIS). Am J Obstet Gynecol. 2013;208(4):327-e1. doi:10.1016/j.ajog.2012.12.025

8.        Meister MR, Cahill AG, Conner SN, Woolfolk CL, Lowder JL. Predicting obstetric anal sphincter injuries in a modern obstetric population. Am J Obstet Gynecol. 2016;215(3):310-e1. doi:10.1016/j.ajog.2016.02.041

9.        Dedeli Ö, Fadıloğlu Ç, Turan İ, Bor S. Prevalance of fecal incontinence and its effect on quality of life in elderly individuals living in nursing homes in the city of Izmir. Turk J Geriatrics. 2008;11(1):33-41.

10.      Nordenstam J, Mellgren A, Altman D, López A, Johansson C, Anzén B, et al. Immediate or delayed repair of obstetric anal sphincter tears—a randomised controlled trial. BJOG. 2008;115(7):857-65.

11.      Harvey MA, Pierce M, Walter JE, Chou Q, Diamond P, Epp A, et al. Obstetrical anal sphincter injuries (OASIS): prevention, recognition, and repair. J Obstet Gynaecol Can. 2015;37(12):1131-48. doi:10.1016/S1701-2163(16)30081-0

12.      Andrews V, Sultan AH, Thakar R, Jones PW. Occult anal sphincter injuries—myth or reality?. BJOG. 2006;113(2):195-200. doi:10.1111/j.1471-0528.2006.00799.x

13.      Von Theobald P, Bohrer M, Lorrain S, Iacobelli S. Risk factors associated with severe perineal tears: A five-year study. J Gynecol Obstet Hum Reprod. 2020;49(7):101820. doi:10.1016/j.jogoh.2020.101820