Interventions for women in subsequent pregnancies following obstetric anal sphincter injury to reduce the risk of recurrent injury and associated harms.
BACKGROUND
Perineal damage occurs frequently during childbirth, with severe damage involving injury to the anal sphincter reported in up to 18% of vaginal births. Women who have sustained anal sphincter damage are more likely to suffer perineal pain, dyspareunia (painful sexual intercourse), defaecatory dysfunction, and urinary and faecal incontinence compared to those without damage. Interventions in a subsequent pregnancy may be beneficial in reducing the risk of further severe trauma and may reduce the risk of associated morbidities.


OBJECTIVE
To examine the effects of Interventions for women in subsequent pregnancies following obstetric anal sphincter injury for improving health.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014).


METHODS
Randomised controlled trials, cluster-randomised trials and multi-arm trials assessing the effects of any intervention in subsequent pregnancies following obstetric anal sphincter injury to improve health. Quasi-randomised controlled trials and cross-over trials were not eligible for inclusion.


METHODS
No trials were included. In future updates of this review, at least two review authors will extract data and assess the risk of bias of included studies.


RESULTS
No eligible completed trials were identified. One ongoing trial was identified.


CONCLUSIONS
No relevant trials were included. The effectiveness of interventions for women in subsequent pregnancies following obstetric anal sphincter injury for improving health is therefore unknown. Randomised trials to assess the relative effects of interventions are required before clear practice recommendations can be made.
Maternal and Child Health, Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, UK, BD9 6RJ.
Diane
D
Farrar
Derek J
DJ
Tuffnell
Carmel
C
Ramage
D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D011247:Pregnancy; D012008:Recurrence