Perineal repair technique after obstetric trauma
Abstract
Obstetric anal
sphincter injury is one of the most serious postpartum conditions. According to
global statistics, 8–11% of natural births are complicated by sphincter trauma.
In Russia, about 235,000 natural births per year are complicated by grade
III–IV perineal ruptures with an extremely high risk of developing anal
incontinence. The aim of this work is to structure modern data on the technique
of restoring the muscular frame of the anal canal after obstetric anal
sphincter injuries.
Keywords:fecal incontinence; OASIS; sphincteroplasty
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Markaryan D.R., Garmanova T.N., Kazachenko E.A.,
Lukianov A.M., Agapov M.A. Perineal repair technique after obstetric trauma.
Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 137–43.
DOI: https://doi.org/10.33029/2308-1198-2022-10-3-137-143
(in Russian)
References
1. Practice Bulletin No. 165: prevention and management of obstetric lacerations at vaginal delivery. Obstet Gynecol. 2016; 128 (1): e1–15. DOI: https://doi.org/10.1097/AOG.0000000000001523
2. Dudding T.C., Vaizey C.J., Kamm M.A. Obstetric anal sphincter injury: incidence, risk factors, and management. Ann Surg. 2008; 247 (2): 224–37. DOI: https://doi.org/10.1097/SLA.0B013E318142CDF4
3. Meister M.R., et al. Techniques for repair of obstetric anal sphincter injuries. Obstet Gynecol Surv. 2018; 73 (1): 33–9. DOI: https://doi.org/10.1097/OGX.0000000000000521
4. Aleksandrova G.A., et al. Main indicators of maternal and child health, activities of child protection and obstetric services in the Russian Federation. Moscow, 2019. (in Russian)
5. Harvey M.A., et al. Obstetrical anal sphincter injuries (OASIS): prevention, recognition, and repair. J Obstet Gynaecol Can. 2015; 37 (12): 1131–48. DOI: https://doi.org/10.1016/S1701-2163(16)30081-0
6. Andrews V., et al. Occult anal sphincter injuries – myth or reality? BJOG. 2006; 113 (2): 195–200. DOI: https://doi.org/10.1111/j.1471-0528.2006.00799.x
7. Delancey J.O.L., Toglia M.R., Perucchini D. Internal and external anal sphincter anatomy as it relates to midline obstetric lacerations. Obstet Gynecol. 1997; 90 (6): 924–7. DOI: https://doi.org/10.1016/S0029-7844(97)00472-9
8. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. Obstet Gynecol. 2018; 132 (3): e103–19. DOI: https://doi.org/10.1097/AOG.0000000000002833
9. Duggal N., et al. Antibiotic prophylaxis for prevention of postpartum perineal wound complications: a randomized controlled trial. Obstet Gynecol. 2008; 111 (6): 1268–73. DOI: https://doi.org/10.1097/AOG.0b013e31816de8ad
10. Katz S., Izhar M., Mirelman D. Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg. 1981; 194 (1): 35–41. DOI: https://doi.org/10.1097/00000658-198107000-00007
11. Fernando R.J. et al. Methods of repair for obstetric anal sphincter injury. Cochrane Database Syst Rev. 2013; 12: CD002866. DOI: https://doi.org/10.1002/14651858.CD002866.pub3
12. Bruno Roche. Sphincteroplasty: Technique and Results. Outpatient Clinic for Surgery; Unit for Proctology; University Hospital of Geneva, P. 1–10. (Bruno.roche@hcuge.ch)