Sphincter rupture and anal incontinence

Abstract

Dear Sir, The interesting article by Pinta et al. (Sphincter rupture and anal incontinence after first vaginal delivery. Acta Gynecol Scand 2004; 83: 917–22) might need some clarification because of Table V, which states that three of the babies were born face presenting. It is unlikely that this cohort would contain three cases of such a rare malpresentation, and even more unlikely that two of these would have been delivered using the vacuum extractor, which is generally considered contraindicated in these cases. Most likely, this is just a case of mislabeling occiput posterior positions, but perhaps it should be pointed out, Acta being an obstetric journal.