MacArthur C, Bick D E, Keighley M R
Department of Public Health and Epidemiology, Medical School, University of Birmingham, Edgbaston, UK.
Br J Obstet Gynaecol. 1997 Jan;104(1):46-50. doi: 10.1111/j.1471-0528.1997.tb10648.x.
To measure the prevalence and severity of postpartum faecal incontinence, especially new incontinence, and to identify obstetric risk factors.
A cohort study with information on symptoms collected in home-based interviews and obstetric data from hospital casenotes.
Deliveries from a maternity hospital in Birmingham.
Nine hundred and six women interviewed a mean of 10 months after delivery.
New faecal incontinence starting after the birth, including frank incontinence, soiling and urgency.
Thirty-six women (4%) developed new faecal incontinence after the index birth, 22 of whom had unresolved symptoms. Twenty-seven had symptoms several times a week, yet only five consulted a doctor. Among vaginal deliveries, forceps and vacuum extraction were the only independent risk factors: 12 (33%) of those with new incontinence had an instrumental delivery compared with 114 (14%) of the 847 women who had never had faecal incontinence. Six of those with incontinence had an emergency caesarean section but none became incontinent after elective sections.
Faecal incontinence as an immediate consequence of childbirth is more common than previously realised, and medical attention is rarely sought. Forceps and vacuum extraction deliveries are risk factors, with no protection demonstrated from emergency caesarean section. Identification and treatment is a priority.
测量产后粪便失禁的患病率和严重程度，尤其是新发失禁，并确定产科危险因素。
一项队列研究，通过在家访中收集症状信息以及从医院病历中获取产科数据。
伯明翰一家妇产医院的分娩情况。
906名女性，平均在产后10个月接受访谈。
产后出现的新发粪便失禁，包括完全失禁、弄脏内裤和便急。
36名女性（4%）在本次分娩后出现新发粪便失禁，其中22名症状未缓解。27名女性每周出现数次症状，但只有5名咨询过医生。在阴道分娩中，产钳和真空吸引是仅有的独立危险因素：新发失禁的女性中有12名（33%）接受了器械助产，而847名从未有过粪便失禁的女性中有114名（14%）接受了器械助产。失禁女性中有6名接受了急诊剖宫产，但择期剖宫产术后无人出现失禁。
分娩后立即出现的粪便失禁比之前认为的更为常见，且很少寻求医疗关注。产钳和真空吸引分娩是危险因素，急诊剖宫产未显示出有保护作用。识别和治疗是当务之急。
