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Objective: To determine the frequency of urinary and fecal incontinence and observe the effects of mode of delivery and perineal injury at 6 weeks and 1 year postpartum.
Methodology: This prospective cohort, multi centric study was carried out at Quaid-e-Azam International Hospital and Al-Sadiq Saad Shaheed Hospital for 1 year from March 2018 to February 2019. One hundrend and twently participants in early and mid pregnancy were recruited at <30 weeks of gestation and were followed at 6 weeks and 12 months postpartum. The effect of delivery mode was determined by division into, vaginal and operative groups. Vaginal delivery group was further studied for the application of instruments and extent of the perineal injury. The severity of symptoms were considered mild, moderate, and severe.
Results: The mean age of females was 24.32±13.96 years. The mean gestational age at presentation was 26.21±7.18 weeks. There were 20 (16.7%) females who had a delivery through lower segment cesarean section, while 82 (68.3%) had spontaneous vaginal delivery, 11 (9.17%) had vacuum delivery and 7(5.8%) cases had a forceps delivery. Episiotomy was performed in 72 (60%) cases, 1st degree perineal tears occurred in 6 (5%) cases, 2nd degree perineal tears occurred in 04 (3.33%) cases and 3rd degree perineal tears occurred in 2 (1.66%) cases. There was a significant effect of mode of delivery on urinary incontinence, fecal incontinence, and double incontinence after 6 weeks and 12 months of delivery and females who had vaginal delivery showed more incontinence than females underwent cesarean delivery and no females showed urinary incontinence who underwent cesarean delivery (p<0.05).
Conclusion: UI and AI are prevalent among women during postpartum period. Are more common after vaginal delivery especially operative vaginal delivery. Perineal injury contributes a lot, to the severity of symptoms.
Ghazala Sadiq, Shahzina John. (2020) Effects of Mode of Delivery and Perineal Injury on the Prevalence of Urinary and Fecal Incontinence, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-10, Issue-1.
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