Recent impact of anal sphincter injury on overall Caesarean section incidence.
BACKGROUND
Because of increasing recognition of obstetric anal sphincter injury and faecal incontinence, we examined the recent impact of these indications on our institutional Caesarean section incidence.


METHODS
Retrospective review of the indications for multiparous Caesarean section was performed at the National Maternity Hospital for the 4 years 2000-2003, inclusive, to identify women in whom previous anal sphincter injury was an indication. Individual charts were reviewed and data regarding the nature and extent of previous anal sphincter injury were obtained.


RESULTS
Among 17 586 consecutive multiparous deliveries, previous anal sphincter trauma constituted the indication for Caesarean delivery in 67 women, representing 0.4% of all multiparae, 2.9% of multiparous Caesarean sections and 1.3% of all Caesarean sections performed. Fifty (85%) of the 67 women who opted for prelabour Caesarean delivery following previous obstetric anal sphincter injury had symptoms of faecal incontinence (mean continence score 5, range 1-17).


CONCLUSIONS
Notwithstanding recent increased awareness and documentation, anal sphincter problems represent a small influence on total Caesarean incidence.
Mahony
Rhona
R
Department of Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Dublin, Ireland.
O'Herlihy
Colm
C
D001003:Anal Canal / Q000293:injuries*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data; D004841:Episiotomy / Q000009:adverse effects / Q000706:statistics & numerical data; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008485:Medical Audit; D008499:Medical Records; D017063:Outcome Assessment, Health Care; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies