title: Using the Brink score to predict postpartum anal incontinence.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Virginia G
authors.initials: VG
authors.lastname: King
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Boyles
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Worstell
authors.forename: Joy
authors.initials: J
authors.lastname: Zia
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Clark
authors.forename: W Thomas
authors.initials: WT
authors.lastname: Gregory
mesh_terms: 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