Abstract
A prospective cohort study was undertaken to evaluate the impact of pregnancy and the first delivery on the defecatory symptoms and to identify associated factors. Included were 487 nulliparous pregnant women who completed four questionnaires. Flatus and fecal incontinence, constipation, and painful defecation are already present in early pregnancy and are significantly predictive for reporting symptoms after delivery, except for fecal incontinence. A third or fourth degree sphincter tear was significantly associated with fecal incontinence 12 months postpartum and with de novo fecal incontinence, while other factors associated with de novo onset of symptoms were of borderline significance. Defecation symptoms already present in early pregnancy are highly predictive for reported symptoms at 12 months postpartum except for fecal incontinence that is mainly related to anal sphincter lesion. Therefore, investigating the effects of childbirth in general on the anorectal function is not justified without knowledge of this function during pregnancy.
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Abbreviations
- DDI:
-
Defecatory distress inventory
- UDI:
-
Urogenital distress inventory
- BMI:
-
Body mass index
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Appendix 1
Appendix 1
Defecation Distress Inventory
Symptom | Question | Scoring system |
|---|---|---|
Constipation * | Do you have less than 3 bowel movements a week? | Yes = symptom is present |
Do you have to strain > 25% of the time to have a bowel movements? | No= symptom is absent | |
Sensation of anal blockage | Do you ever experience a sensation of anal blockage when you have your bowel movement? | Yes = symptom is present |
No= symptom is absent | ||
Feeling of incomplete evacuation | Do you experience a feeling of incomplete evacuation after bowel movement? | Yes = symptom is present |
No= symptom is absent | ||
Painful defecation ** | Do you experience pain related to urgency for bowel movement? | Yes = symptom is present |
Do you experience pain during or shortly after a bowel movement? | No= symptom is absent | |
Fecal incontinence ** | Do you experience incontinence for liquid stool? | Yes = symptom is present |
Do you experience incontinence for solid stool? | No= symptom is absent | |
Flatus incontinence | Do you experience incontinence for gas? | Yes = symptom is present |
No= symptom is absent |
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van Brummen, H.J., Bruinse, H.W., van de Pol, G. et al. Defecatory symptoms during and after the first pregnancy: prevalences and associated factors. Int Urogynecol J 17, 224–230 (2006). https://doi.org/10.1007/s00192-005-1351-0
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DOI: https://doi.org/10.1007/s00192-005-1351-0