ASSESSMENT OF ANAL SYMPTOMS IN PRIMIPAROUS WOMEN FOLLOWING SPONTANEOUS VAGINAL BIRTH AT TERM

Abstract

Background: The purpose of this prospective survey‐design study of primiparas was to assess anal symptoms following spontaneous vaginal birth at term. Methods: A survey was designed for the study using the Wexner Scale. Inclusion criteria: primiparas undergoing spontaneous vaginal birth with either intact, first or second‐degree laceration; read and write English; and no previous anal injury or defect. P < .05 was statistically significant. Demographic and labor variables along with Wexner Scale results were collected. Results: 322 postpartum women were enrolled with 164 responding for a 51% return rate. Two demographic and labor‐related variables by laceration severity proved significant: maternal age (P= .001) and fetal weight at birth (P= .01). Within the Wexner Scale, when frequency of items was grouped, the odds of frequent liquid stool incontinence were 1.3 times higher in the second‐degree laceration group although not statistically significant. The odds of frequent uncontrollable flatus were 1.5 times higher in the second‐degree laceration group although not statistically significant (P= 0.2). Conclusion: The significant findings of age and fetal size are consistent with other studies assessing anal symptoms. Uncontrollable flatus needs a larger power analysis to show any significance. In women without significant perineal tears, age and fetal size can add to anal symptoms postpartum, and with increased laceration severity, more anal symptoms were noted.