Laine Katariina, Skjeldestad Finn Egil, Sandvik Leiv, Staff Anne Cathrine
Department of Obstetrics and Department of Gynaecology, Oslo University Hospital, Ullevål, Pb 4965, Nydalen, 0424 Oslo, Norway ; Faculty of Medicine, University of Oslo, Norway.
ISRN Obstet Gynecol. 2013 May 29;2013:947572. doi: 10.1155/2013/947572. Print 2013.
The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, medication use, and comorbidity was posted to women when invited to the ultrasound examination. Results. Prevalence of self-reported anal incontinence (St. Mark's score ≥ 3) was the lowest in the group of women with a previous cesarean section only (6.4%) and the highest among women with a previous delivery complicated by obstetric anal sphincter injury (24.4%). Among nulliparous women the prevalence of anal incontinence was 7.7% and was associated to low educational level and comorbidity. Prevalence of anal incontinence increased with increasing parity. Urinary incontinence was associated with anal incontinence in all parity groups. Conclusions. Anal incontinence was most frequent among women with a history of obstetric anal sphincter injury. Other obstetrical events had a minor effect on prevalence of anal incontinence among parous women. Prevention of obstetrical sphincter injury is likely the most important factor for reducing bothersome anal incontinence among fertile women.
本研究旨在评估孕中期未经过筛选的孕妇群体中肛门失禁的患病率及危险因素。在挪威奥斯陆的一家大学医院，对参加常规超声检查的孕妇进行了一项调查。当受邀参加超声检查时，向孕妇发放了一份包含105项内容的问卷，这些内容涉及肛门失禁（包括圣马克评分）、尿失禁、用药情况及合并症。结果：自我报告的肛门失禁（圣马克评分≥3）患病率在仅既往有剖宫产史的女性组中最低（6.4%），在既往分娩合并产科肛门括约肌损伤的女性中最高（24.4%）。在未生育女性中，肛门失禁患病率为7.7%，且与低教育水平及合并症相关。肛门失禁患病率随产次增加而升高。在所有产次组中，尿失禁均与肛门失禁相关。结论：有产科肛门括约肌损伤史的女性中肛门失禁最为常见。其他产科事件对经产妇肛门失禁患病率的影响较小。预防产科括约肌损伤可能是降低育龄女性中令人困扰的肛门失禁的最重要因素。
