title: Faecal incontinence after first instrumental vaginal delivery using Thierry's spatulas.
abstract: OBJECTIVE
  The purpose of this study is to estimate the prevalence of faecal incontinence after first vaginal delivery and to assess the impact of Thierry's spatulas-assisted delivery.
  
  
  METHODS
  A prospective observational study of primiparas who underwent a vaginal delivery at term was conducted. Faecal incontinence was assessed at 2 and 6 months postpartum by a questionnaire (Wexner score >or=5 was considered significant). Univariate and multivariate analyses were performed.
  
  
  RESULTS
  Five hundred thirty-eight women were recruited with undergoing 176 spatulas-assisted deliveries and 362 spontaneous vaginal deliveries. The response rate was 85.9% (2 months) and 80.5% (6 months). The prevalence of faecal incontinence was similar between the two groups at 2 months (14.3% and 9.7%). Episiotomy (odds ratio [OR] = 5.0) and maternal age over 35 years (OR = 4.1) were independently associated with faecal incontinence after adjustment.
  
  
  CONCLUSIONS
  Anal symptoms are common after the first vaginal delivery. Thierry's spatulas do not increase the prevalence of faecal incontinence after delivery given that an episiotomy is performed.
authors.affiliation: CHU de Toulouse, Service de gynécologie obstétrique, Hôpital Paule de Viguier, 330 avenue de Grande-Bretagne, 31059, Toulouse, France. olivier.parant@wanadoo.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Parant
authors.forename: Caroline
authors.initials: C
authors.lastname: Simon-Toulza
authors.forename: Christelle
authors.initials: C
authors.lastname: Cristini
authors.forename: Christophe
authors.initials: C
authors.lastname: Vayssiere
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Reme
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000295:instrumentation; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D014621:Vagina
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