产后肛门失禁的发病率及危险因素：一项对503例病例的前瞻性研究。

Incidence and risk factors of postpartum anal incontinence: a prospective study of 503 cases.

作者信息

Malek-mellouli Monia, Assen Soulé, Ben Amara Fethi, Gada Hamdi, Masmoudi Kacem, Reziga Hédi

出版信息

Tunis Med. 2014 Feb;92(2):159-63.

Abstract

BACKGROUND

Background: Anal incontinence is a devastating functional postpartum complication. it can cause deep deterioration in the quality of life.

AIM

To assess the incidence of postpartum anal incontinence (PPAI) and the major risk factors predisposing for it in the short and middle terms.

METHODS

This prospective observational study was conducted in the department of Obstetrics and Gynecology B in the Maternity and Neonatology Center of Tunis between March 1st and july 31st, 2009.

RESULTS

Five hundred and three women were included. PPAI was 4.2% on the fourth day postpartum and 4% between weeks 6 and 8 postpartum. Predisposing factors to 4th day PPAI were forceps delivery (p<0.001), prolonged second stage of labor> 5hours (p=0.047), expulsion phase > 20mn (p<0.001), uterine revision (P=0.001) and first degree perineal lacerations (p<0.001). Between 6 and 8 weeks postpartum, identified risk factors were Shoulder dystocia (p<0.001), anu-vulvar distance < 2cm, perineal scars and transverse abdominal diameter >105mm (p<0.001).

CONCLUSION

Preventive measures must be implemented in patients with PPAI risk factors.

摘要

背景

肛门失禁是一种严重的产后功能并发症。它会导致生活质量严重下降。

目的

评估产后肛门失禁（PPAI）的发生率以及中短期导致其发生的主要危险因素。

方法

这项前瞻性观察研究于2009年3月1日至7月31日在突尼斯母婴中心的妇产科B进行。

结果

纳入503名女性。产后第4天PPAI发生率为4.2%，产后6至8周为4%。产后第4天PPAI的诱发因素包括产钳分娩（p<0.001）、第二产程延长>5小时（p=0.047）、娩出期>20分钟（p<0.001）、子宫复位（P=0.001）和一度会阴裂伤（p<0.001）。产后6至8周，确定的危险因素有肩难产（p<0.001）、肛门-外阴距离<2cm、会阴瘢痕和腹横径>105mm（p<0.001）。