Using the Brink score to predict postpartum anal incontinence.
OBJECTIVE
To evaluate whether antepartum pelvic floor muscle strength, as measured by the Brink scale, predicts postpartum anal incontinence.


METHODS
This prospective cohort study of primigravid women used validated questionnaires and standardized pelvic examinations to evaluate subjects during the third trimester and at 2 postpartum time points.


RESULTS
Of the initial 129 subjects, 102 and 81 completed 2 week and 6 month postpartum visits. 35% had cesarean deliveries. The antepartum prevalence of fecal incontinence (14%) did not differ significantly from the postpartum (17% at 2 weeks, 11% at 6 months). However, the prevalence of flatal incontinence fell from antepartum (65%) to postpartum (47% at 2 weeks, P = .001; 49% at 6 months, P = .012). Mean Brink score decreased postpartum; no correlations were found between Brink score and questionnaire scores.


CONCLUSIONS
Anal incontinence symptoms are common in the third trimester of a first pregnancy and may regress or resolve after delivery. Brink score did not predict postpartum anal incontinence.
King
Virginia G
VG
Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
Boyles
Sarah H
SH
Worstell
Teresa R
TR
Zia
Joy
J
Clark
Amanda L
AL
Gregory
W Thomas
WT
D000328:Adult; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000503:physiopathology*; D011795:Surveys and Questionnaires