Re: Episiotomy and anal incontinence
From: Bernard Cristalli (bcrist@club-internet.fr)
Thu Jan 6 23:50:29 2000
Agreed for the risk associated with epis and that epis don't avoid severe
lacerations but...
it is a retrospective study, so in this population epis have been done when
the baby was big, when the situation was thought to lead to a laceration.
--
Bernard Cristalli MD AMACOG
AIHP - ACCA
Paris France
Bernard.Cristalli@CliniquedelEssonne.fr
http://www.CliniquedelEssonne.fr
http://www.obgyn.net/corresp/cristalli.htm
'64 Mk2 3.8
> De : gwaldby@willinet.net Fri Jan 7 03:27:05 2000
> Répondre à : ob-gyn-l@obgyn.net
> Date : Thu, 6 Jan 2000 20:25:56 -0600
> À : Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
> Objet : Episiotomy and anal incontinence
>
> EPISIOTOMY INCREASES THE RISK OF ANAL
> INCONTINENCE
>
> (Midline episiotomy and anal incontinence: retrospective
> cohort study)
> http://www.bmj.com/cgi/content/full/320/7227/86
>
> Women who undergo episiotomy during childbirth have
> higher rates of anal incontinence during the first six months
> after giving birth compared to women who did not have
> episiotomies and even compared to those who experienced
> perineal tearing, report researchers in this week's BMJ.
>
> Dr Lisa Signorello and colleagues from Harvard Medical
> School investigated 209 women who underwent a midline
> episiotomy whilst delivering a full term singleton baby
> vaginally; 206 who experienced spontaneous perineal tearing
> and 211 who experienced neither. They found that compared
> with women who tore naturally, episiotomy tripled the risk of
> faecal incontinence and doubled the risk of flatus incontinence
> in the six months after giving birth.
>
> Signorello et al also determined that this effect of episiotomy
> was not due to its frequent association with instrumental
> delivery (for example forceps) and was independent of
> maternal age and complications during labour.
>
> Based on their findings the authors conclude that episiotomy
> is not effective in protecting the perenium and sphincters
> during child birth and that the restricted use of episiotomy
> may prevent anal incontinence.
>
> Contact:
>
> Dr Lisa Signorello, Study Co-ordinator, International
> Epidemiology Institute, Rockville, USA
> Email: lbsignore@aol.com
>
> Or
>
> Dr Bernard Harlow, Obstetrics and Gynaecology
> Epidemiology Center, Brigham and Women's Hospital,
> Harvard Medical School, Boston, U
>
