Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany.
Int J Gynaecol Obstet. 2013 Apr;121(1):74-7. doi: 10.1016/j.ijgo.2012.10.023. Epub 2013 Jan 8.
To determine obstetric variables associated with the long-term prevalence of flatal and/or fecal incontinence among women who sustained obstetric anal sphincter injuries (OASIS).
In a retrospective study of women who gave birth between January 1974 and December 1983 at the University Women's Hospital, Tuebingen, Germany, women with OASIS (n=460) were identified on the basis of chart review. Eligible women were recruited to participate in a telephone interview regarding symptoms and their retrospective preference about elective cesarean delivery.
The records of 20 999 deliveries, including all modes of delivery, within the 10-year study period were reviewed, and 99 women who sustained OASIS agreed to participate. The mean follow-up was 27.5±2.4 years. Among the participants, 39.4% reported fecal or flatal incontinence. Operative vaginal delivery (forceps and/or vacuum) was significantly associated with fecal but not flatal incontinence (odds ratio, 3.27; 95% confidence interval, 1.12-9.56, P=0.026). Only 9% of women with flatal incontinence and 13% of women with fecal incontinence would have opted retrospectively for cesarean delivery.
Operative vaginal delivery was significantly associated with fecal but not flatal incontinence. No other obstetric variables tested were associated with the long-term prevalence of fecal or flatal incontinence.
确定与经产妇发生产科肛门括约肌损伤（OASIS）后长期存在的肛门排气和/或粪便失禁相关的产科变量。
在德国图宾根大学妇女医院进行的一项回顾性研究中，根据病历回顾确定了 1974 年 1 月至 1983 年 12 月分娩的妇女中有 OASIS（n=460）的妇女。合格的妇女被招募参加电话访谈，内容是关于症状及其对选择性剖宫产的回顾性偏好。
回顾了 10 年研究期间所有分娩方式的 20999 次分娩记录，其中 99 名发生 OASIS 的妇女同意参与。平均随访时间为 27.5±2.4 年。在参与者中，39.4%报告有粪便或肛门排气失禁。阴道助产（产钳和/或真空）与粪便失禁显著相关（比值比，3.27；95%置信区间，1.12-9.56，P=0.026）。只有 9%的肛门排气失禁妇女和 13%的粪便失禁妇女会回顾性选择剖宫产。
阴道助产与粪便失禁显著相关，但与肛门排气失禁无关。未发现其他产科变量与粪便或肛门排气失禁的长期发生率相关。
