Volume 4 No. 1, January 2009

The impact of forceps and vacuum assisted vaginal Delivery on anal sphincter function
Lamiaa Al-Ahwal⁽¹⁾, Esmat H. Esmaiel⁽¹⁾, Khaled Dewan⁽²⁾ & Mohamed Ezz El-Din⁽³⁾

Departments of obstetrics & Gynecology⁽¹⁾, Radiology⁽²⁾ and Physiotherapy⁽³⁾,Faculty of Medicine, Tanta University, Egypt

Tanta Med. Sc. J 2009; 4(1):4-8

Abstract provided by Publisher

Aim: To assess anal sphincter function following forceps and vacuum assisted vaginal delivery. Patients & Methods: The study included 64 primiparous women with indicated instrumental delivery. The women included in the study were random¬ized to either a vacuum or low forceps assisted vaginal delivery. Follow up con¬sisted of clinical evaluation, anal manometry and endoanal ultrasound at three months post-partum. Results: 30 women delivered with forceps and 34 with vacuum assistance. There were no statistical differences in the antecedent ante¬natal factors between both groups. A third degree perineal tear followed 5(17%) forceps and 2 (6%) vacuum deliveries. 18(60%) women complained of altered faecal continence after forceps delivery compared with 11(32%) following vacuum delivery , three months post-partum (RR 2.73, 95%CI 1.39-5.77). Endoanal ultrasound was reported as abnormal following 16(35%) forceps deliveries and 15(44%) vacuum deliveries (RR 1.2, 95% CI 0.64-2.61). Median anal canal resting pressure was significantly lower following forceps delivery compared with vacuum delivery. There were no significant differences in degree of ultrasound abnormali¬ty between the two groups. Conclusions: Based on continence outcome, vacuum should be pre¬ferred than forceps in assisted delivery as symptoms of altered foecal continence are significantly more common following forceps delivery.

ICID 885195