Factors that influence patient preference for mode of delivery following an obstetric anal sphincter injury

被引:8
作者
Long, Emma [1 ]
Jha, Swati [1 ]
机构
[1] Sheffield Teaching Hosp NHS Fdn Trust, Dept Urogynaecol, Sheffield S10 2SF, S Yorkshire, England
关键词
Anal sphincter injury; Caesarean section; Mode of delivery; OASI; Vaginal delivery; UROGYNAECOLOGY; RISK;
D O I
10.1016/j.ejogrb.2017.12.002
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Purpose: A common indication for elective caesarean is previous obstetric anal sphincter injury (OASI). This study aims to identify factors that influence womens' preferences regarding mode of delivery (MoD) in a subsequent pregnancy following an OASI. Methods: 100 consecutive women who sustained an OASI completed a questionnaire when attending postnatal follow up at a perineal trauma clinic. They also completed ePAQ-PF to assess pelvic floor symptoms. Data was collated and percentages generated for each response. A chi-squared calculation was used for preferred MoD. Results: In total, 75 women were Primiparous and 25 Multiparous. 20% of women were advised to have a caesarean, with the remainder advised either a vaginal delivery or further investigations. 79% of women had a 3a/3b tear and 21% of women had a 3c/4th degree OASI. Based on women's preferences, those who sustained a 3c/4th degree tear were more likely to opt for CS than a 3a/b degree tear (p <0.001). Bowel symptoms per se did not correlate with choice of MoD in either group. In women with 3c/4th OASI vaginal or sexual symptoms did not impact on the decision regarding choice of delivery but in women who sustained a 3a/b tear the impact on sexual function appears to be the commonest symptom in those who wished a caesarean section. Conclusion: Women with 3c/4th OASI are more likely to accept a planned CS. Bowel symptoms appear to have little impact on this but in women with lower grade tears sexual symptoms have the greatest impact on preferred MoD. (C) 2017 Elsevier B.V. All rights reserved.
引用
收藏
页码:28 / 33
页数:6
相关论文
共 16 条
[1]   Delivery outcomes and events in subsequent pregnancies after previous anal sphincter injury [J].
Ali, Amanda ;
Glennon, Kate ;
Kirkham, Colin ;
Yousif, Seifeldin ;
Eogan, Maeve .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2014, 174 :51-53
[2]   The impact of first birth obstetric anal sphincter injury on the subsequent birth: a population-based linkage study [J].
Ampt, Amanda J. ;
Roberts, Christine L. ;
Morris, Jonathan M. ;
Ford, Jane B. .
BMC PREGNANCY AND CHILDBIRTH, 2015, 15
[3]  
[Anonymous], 2016, HES DATA 2013 14 201
[4]  
[Anonymous], 2015, WHO statement on caesarean section rates
[5]   Risk of recurrence and subsequent delivery after obstetric anal sphincter injuries [J].
Baghestan, E. ;
Irgens, L. M. ;
Bordahl, P. E. ;
Rasmussen, S. .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2012, 119 (01) :62-69
[6]   Understanding women's experiences of electronic interviewing during the clinical episode in urogynaecology: a qualitative study [J].
Dua, Anupreet ;
Jones, Georgina ;
Wood, Hilary ;
Sidhu, Herjit .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1969-1975
[7]   Does anal sphincter injury preclude subsequent vaginal delivery? [J].
Fitzpatrick, M. ;
Cassidy, M. ;
Barassaud, M. L. ;
Hehir, M. P. ;
Hanly, A. M. ;
O'Connell, P. R. ;
O'Herlihy, C. .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2016, 198 :30-34
[8]   Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence [J].
Jango, Hanna ;
Langhoff-Roos, Jens ;
Rosthoj, Susanne ;
Sakse, Abelone .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 214 (06)
[9]   Risk factors for recurrent obstetric anal sphincter injury (rOASI): a systematic review and meta-analysis [J].
Jha, Swati ;
Parker, Victoria .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2016, 27 (06) :849-857
[10]   Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF [J].
Jones, G. L. ;
Radley, S. C. ;
Lumb, J. ;
Jha, S. .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2008, 19 (10) :1337-1347