Differences in outcomes after third- versus fourth-degree perineal laceration repair: A prospective study - 18/08/11
, Elizabeth H. Lamb, RNC, NP a, Viswanathan Ramakrishnan, PhD b
Reprint requests: Catherine M. Nichols, MD, 1250 E Marshall St, Box 980034, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0034.Abstract |
Objective |
The purpose of this study was to compare outcomes after third- versus fourth-degree laceration repair.
Study design |
Fifty-six primiparous women who sustained a third- or fourth-degree tear were enrolled at delivery and demographic and obstetric data were collected. At 6 weeks' postpartum, subjects completed a bowel function questionnaire and endoanal ultrasonography was performed. Fisher exact test and chi-square were used for statistical analysis.
Results |
Thirty-nine women with third- and 17 with fourth-degree tears were enrolled. Subjects with fourth- were more likely to report bowel symptoms (59% vs 28%, P=.03), and to demonstrate persistent combined defects of the internal (IAS) and external anal sphincter (EAS) (48% vs 8%, P=.002) than third-degree tears. Combined defects were associated with the highest risk of bowel symptoms (OR 18.7, 95% CI 3-101, P < .001).
Conclusion |
Bowel symptoms were more common after fourth- than third-degree repair, and may be secondary to higher rates of combined defects of the IAS and EAS.
Le texte complet de cet article est disponible en PDF.Key words : Anal sphincter, Third-degree laceration, Fourth-degree laceration, Anal incontinence, Endoanal ultrasonography
Plan
Vol 193 - N° 2
P. 530-534 - août 2005 Retour au numéro
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