Dr Rhona Mahoney and colleagues from Ireland determined the effect of further vaginal delivery on anal sphincter function in women after apparently uncomplicated primiparous forceps delivery.
The team compared 52 secundigravid women whose first child was forceps-assisted with a control group of 20 women who had undergone spontaneous first vaginal delivery.
|26% had some minor alteration in fecal continence after the second delivery|
|Diseases of the Colon & Rectum|
Both groups were studied antenatally and again at 12 weeks after second delivery using a standardized bowel function questionnaire, endoanal ultrasound, and anal manometry.
The primary outcome was fecal incontinence score after second delivery.
The researchers found that before second delivery, 39% of the forceps group, and 15% of control subjects reported minor alteration in fecal incontinence.
Endoanal ultrasound was more frequently abnormal.
The researchers observed that median anal canal squeeze, and resting pressures were lower in the forceps group.
The team found no difference in continence score between first and second delivery for the forceps group or control subjects.
However, 26% of women with an abnormal endoanal ultrasound after first forceps delivery developed new or worsening symptoms after second delivery.
Dr Mahony's team concluded, "About a quarter women with occult anal sphincter injury after first forceps delivery experienced some minor alteration in fecal continence after the second delivery."