Details

Autor(en) / Beteiligte

• Marchand, Marie-Claude, PT
• Corriveau, Hélène, PhD
• Dubois, Marie-France, PhD
• Watier, Alain, MD

Titel

Effect of dyssynergic defecation during pregnancy on third- and fourth-degree tear during a first vaginal delivery: a case-control study

Ist Teil von

• American journal of obstetrics and gynecology, 2009-08, Vol.201 (2), p.183.e1-183.e6

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective Determine whether dyssynergic defecation is a risk factor for third- or fourth-degree tear during a first vaginal delivery. Study Design A retrospective case-control study was conducted on 549 primiparous women. The case group (n = 140) sustained an anal sphincter tear and the control group (n = 409) had a perineal laceration lower or equal to a second-degree tear. The Knowles-Eccersley-Scott Symptom questionnaire identified women who had dyssynergic defecation. A logistic regression analysis was performed. Results Anal sphincter tear were 2.94 times higher for women reporting dyssynergic defecation ( P = .002; 95% confidence interval [CI], 1.47-5.88). Odds ratios (ORs) were also significant for forceps ( P < .001; OR, 6.90; 95% CI, 3.27-14.59), vacuum extraction ( P = .009; OR, 2.36; 95% CI, 1.17-4.76), median episiotomy ( P = .009; OR, 2.71; 95% CI, 1.54-4.78), and high infant weight ( P < .001; OR, 2.25 for each 500 g increase; 95% CI, 1.69-2.99). Conclusion Dyssynergic defecation seems to increase anal sphincter tear, but prospective studies are needed to confirm the association.