title: [Predictive factors of 2-month postpartum anal incontinence among patients with an obstetrical anal sphincter injury].
abstract: OBJECTIVE
  To determine prevalence of short-term postpartum anal incontinence after obstetrical anal sphincter injury and prognostic factors.
  
  
  METHODS
  Retrospective study including every patient with an obstetrical anal sphincter injury between January 2006 and December 2012 in one tertiary maternity unit. Patients were interviewed and examined at 2-month postpartum. Anal incontinence was defined by the presence of at least one of the following symptoms: flatus incontinence, faecal incontinence and faecal urgency.
  
  
  RESULTS
  Among 17,110 patients who delivered vaginally during period study, 134 (0.8%) presented an anal sphincter injury. Postpartum obstetrical data were available for 110 of them. Among those patients, 50 women (45.5%) had at least one symptom of anal incontinence at 2-month postpartum and 8 (7.3%) had faecal incontinence. Only maternal age and second stage duration were significantly associated with anal incontinence after obstetrical anal sphincter injury. The degree of sphincter damage at delivery (IIIa, b, c, IV) was not associated with the risk of anal incontinence at 2-month postpartum.
  
  
  CONCLUSIONS
  Maternal age and second stage duration were the only risk factor for anal incontinence after obstetrical anal sphincter injury in this study. High prevalence of anal incontinence at 2-month postpartum of obstetrical anal sphincter injury is observed no matter what is the degree of anal sphincter damage. Our results highlight the importance to diagnose all obstetrical anal sphincter injuries whatever the degree of damage.
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Ménard
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Poupon
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Bourguignon
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Théau
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Goffinet
authors.affiliation: Maternité Port-Royal, groupe hospitalier Cochin-Broca-Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014 Paris, France. Electronic address: camille.le-ray@cch.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Le Ray
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007748:Labor Stage, Second; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011379:Prognosis; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies
keywords: Anal incontinence; Episiotomy; Extraction instrumentale; Incontinence anale; Instrumental delivery; Périnée complet; Sphincter anal injury; Épisiotomie