PRADA: Prevalence of Anal Sphincter Defects After Childbirth
The incidence of obstetric sphincter tears has risen to 15-30% and the prevalence of anal incontinence (AI) symptoms after childbirth may be as high as 40%. The present study aims to evaluate the prevalence of anal sphincter defects after childbirth in primiparous women-
|Condition or Disease||Intervention/Treatment||Phase|
The incidence of sphincter defect in women has raised in recently with current rates as high as 30% after vaginal deliveries. Fecal incontinence could be present at the time of the delivery but it is a real problem longtime after, in women older than 60 years.
It is of great importance not only an early detection but to indicates the best possible management as soon as posible.
The design is a prospective observational study including primiparous woman, without previous anal surgery.
Arms and Interventions
Patients with EAUS pre and postpartum
Other: Endoanal Ultrasound (EAUS)
Endoanal Ultrasound pre- and postpartum
Primary Outcome Measures
- Integrity of anal sphincter [4 months]
No defect detected on EAUS
- Defects on anal canal [4 months]
Disruption of any of the anal canal sphincters
Secondary Outcome Measures
- QoL [4 months]
According to a dedicated questionnaire
- Primiparous pregnant patients aged >18 y, evaluated during pregnancy and after childbirth, including both vaginal and cesarean deliveries.
- Non primiparous patients and patients with a history of anal surgery
Contacts and Locations
|1||Hospital Clinico Lozano Blesa||Zaragoza||Spain||50009|
Sponsors and Collaborators
- Universidad de Zaragoza
- Hospital Clínico Universitario Lozano Blesa
- Instituto de Investigación Sanitaria Aragón
- Principal Investigator: Jose-M Ramirez, Prof, Universidad de Zaragoza
Study Documents (Full-Text)None provided.
- Damon H, Bretones S, Henry L, Mellier G, Mion F. Long-term consequences of first vaginal delivery-induced anal sphincter defect. Dis Colon Rectum. 2005 Sep;48(9):1772-6.
- Harvey MA, Pierce M, Alter JE, Chou Q, Diamond P, Epp A, Geoffrion R, Harvey MA, Larochelle A, Maslow K, Neustaedter G, Pascali D, Pierce M, Schulz J, Wilkie D, Sultan A, Thakar R; Society of Obstetricians and Gynaecologists of Canada. Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair. J Obstet Gynaecol Can. 2015 Dec;37(12):1131-48. Erratum in: J Obstet Gynaecol Can. 2016 Apr;38(4):421. J Obstet Gynaecol Can. 2016 Apr;38(4):421.
- Johannessen HH, Wibe A, Stordahl A, Sandvik L, Mørkved S. Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial. BJOG. 2017 Mar;124(4):686-694. doi: 10.1111/1471-0528.14145. Epub 2016 Jun 7.
- Sultan AH, Thakar R. Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial. Obstet Gynecol. 2005 Nov;106(5 Pt 1):1108-9; author reply 1109.
- Tejedor P, Plaza J, Bodega-Quiroga I, Ortega-López M, García-Olmo D, Pastor C. The Role of Three-Dimensional Endoanal Ultrasound on Diagnosis and Classification of Sphincter Defects After Childbirth. J Surg Res. 2019 Dec;244:382-388. doi: 10.1016/j.jss.2019.06.080. Epub 2019 Jul 17.
- Thomas GP, Gould LE, Casunuran F, Kumar DA. A retrospective review of 1495 patients with obstetric anal sphincter injuries referred for assessment of function and endoanal ultrasonography. Int J Colorectal Dis. 2017 Sep;32(9):1321-1325. doi: 10.1007/s00384-017-2851-3. Epub 2017 Jul 7.