Perineal trauma has been shown to relate to the frequency and severity of postpartum dyspareunia 6. The odds of fecal or urinary incontinence four years after delivery are markedly higher among women who experience pelvic disorder symptoms in the first year after birth 5. The association between previous birth-related pelvic floor muscle trauma and future signs of pelvic organ prolapse has been shown in long-term follow-up studies 4. Grade two and OASI can lead to perineal pain and dyspareunia and increase the risk of concomitant pelvic floor disorders 3. OASI is the most common cause of anal incontinence among women. The prevalence rates of minor (first-degree) and muscular (second-degree) lacerations are estimated according to clinical experience, and these data are not always recorded in patient charts or registers. Women with OASI had significantly higher risks of symptoms of prolapse, urge urinary incontinence, pain, dyspareunia and impacts on daily life.Īpproximately 80% of primiparas suffer from perineal laceration.Īn estimated 40–50% of lacerations involve the perineal muscles, and up to 7% of these women suffer from severe obstetric anal sphincter injury (OASI) 1, 2.
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Pelvic floor dysfunction is common after childbirth, even in women with moderate injury. Women with OASI reported that the injury affected daily life (OR 18 (95% CI 5.1–59)). Dyspareunia was reported by 38% of women, 63% of women in the OASI group (aOR 3.1 (95% CI 1.1–9.0)). Cesarean section was protective against stress incontinence (aOR 0.2 (95% CI 0.1–0.9)). Second-degree tears were a risk factor for stress incontinence (aOR 2.6 (95% CI 1.3–5.1)). Women with no/first-degree injuries, second-degree injuries, third-/fourth-degree injuries (obstetric anal sphincter injury, OASI) and cesarean section were compared.
![severe periods 1 year after xsection severe periods 1 year after xsection](http://islamicsupremacism.com/Islamic_Supremacism/47_Modern_Jurists_%26_Sharia_Scholars_Opinions_on_IS%26J_files/92.jpg)
Self-reported pelvic floor function data were obtained using a web-based questionnaire. A prospective cohort of 776 primiparas were included. The aims of this study were to evaluate pelvic floor dysfunction symptoms one year after delivery and investigate whether adverse functional outcomes after childbirth were related to the degree of perineal injury.