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Delivery and the Pelvic Floor
 Kališ, Vladimír ; Rokyta, Zdeněk (advisor) ; Martan, Alois (referee) ; Roztočil, Aleš (referee)
Vaginal Birth in Primiparas and Anal Incontinence Objective: An investigation of incidence and degree of anal incontinence after vaginal delivery among primiparas and characterizing of the risk factors Design: Prospective observational study Setting: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Pilsen, the Czech Republic Methods: 346 primiparas after consecutive vaginal delivery between 2000 and 2001 were included. All delivered in lithotomy position. Questionnaires were sent few days after delivery and then 2 and 6-9 months later. Analysis of returned questionnaires. 28 obstetric parameteres assessed. Results: 46.5% women responded. 23 women registered leakage of flatus before delivery. Two months postpartum 1 (0.6%) patient reported fecal incontinence and 22 (14.3%) flatus incontinence de novo or impaired already present incontinence. 6-9 months after delivery the same patient (0.6%) reported fecal incontinence and 16 women (10.4%) incontinence of flatus. 10 of them felt impaired quality of life. Anal incontinence gradually improved during the time (in 76%). Risk factors of developing (worsening) of anal incontinence were antenatal anal incontinence (in two months period) and women weight (or BMI) meassured at 6-9 months after birth. None of nine patients after forceps...
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