Prevalence of Anal Incontinence Six Weeks After Vaginal Delivery: Prospective Study in the Three Teaching Hospitals in Addis Ababa, Ethiopia
| dc.contributor.advisor | Dr.Mesfin, Eyasu(Associate Professor of Obstetrics and Gynecology) | |
| dc.contributor.advisor | Dr. Tesfaye, Kiflom(Asst. Professor of Obstetrics and Gynecology) | |
| dc.contributor.author | Abdissa, Kumasa | |
| dc.date.accessioned | 2022-01-28T10:46:49Z | |
| dc.date.accessioned | 2025-01-08T14:27:18Z | |
| dc.date.available | 2022-01-28T10:46:49Z | |
| dc.date.available | 2025-01-08T14:27:18Z | |
| dc.date.issued | 2021-07 | |
| dc.description.abstract | Background: Anal incontinence, defined as the involuntary loss of fecal material or flatus once in a week or more. It ranges in severity from an occasional involuntary leakage of stool or flatus to a complete loss of bowel control. The overall prevalence in the population is reported to be approximately 8.3%. It is associated with reduced quality of life, negative psychogenic effects, and social stigma, yet many women do not report their symptoms or seek treatment. For childbearing women Obstetric anal sphincter injury (OASIS) is a well-known risk factor for AI. However, only half the cases of AI after childbirth can be attributed to OASIS. The other half may in part be caused by clinically unrecognized sphincter injury visible on ultrasound (occult OASIS) or by chronic pudenda neuropathy. Because the long-term success of primary sphincter repair in resolving anal incontinence is reported to be as low as 44%, it is important for health care providers to reduce trauma to the perineum during the second stage of labor to avoid anal sphincter damage. In addition, postpartum care and follow up should not overlook detection and treatment of anal incontinence. Statement of the problem : The overall prevalence of anal incontinence in childbearing wome n ranges from 7% to 15% according to some literatures. Less than 3% of women who do self-report fecal incontinence will have this diagnosis recorded in their medical record. But the real figure of the problem in our population is unknown. The most common risk factor is OASIS which occurs during child birth. Despite the anticipated magnitude of this public health problem, there is limited data on the prevalence of AI after childbirth in our country. Rationale of the study : Obstetrician – gynecologists are in a unique position to identify women with anal incontinence because pregnancy, childbirth, obstetric anal sphincter injuries (OASIS), and pelvic floor dysfunction are important risk factors that contribute to anal incontinence in women. Thus, this study is meant to identify the magni tude of AI, associated factors and increase our diagnosis of AI and suggest possible interventions to prevent the condition. Objectives: To A ssess Prevalence of Anal I ncontinence after vaginal delivery at 6weeks postpartum in three selected teaching hospitals (BLH, GMH and ZMH) in Addis Ababa, Ethiopia, 2021. Methods: A prospective cross sectional study was done to assess the prevalence of a nal incontinence after 6 weeks of vaginal delivery. The study participants will be those women who gave birth through vagin al delivery. Sample sizes of 384 women were studied. The data were collected through questionnaire developed using International Consultation on Incontinence Questionnaire on Urinary Incontinence – Short Form (ICIQ-UI-SF) and risks factors associated with anal incontinence mentioned in different literatures, immediat ely after delivery and 6 weeks later. After data collection, each questionnaire was checked for completeness based on the code given during data collection. Data were entered in to SPSS version 20.5 statistical package. Descriptive statistics like frequency, tables, graphs and descriptive summaries were used to describe the independent variables. The association of anal with independent variables is analyzed individually by binary logistic analysis and final association between dependent and independent variable is analyzed by multiple regression analysis. Result : The prevalence of anal incontinence at 6 weeks of vaginal delivery was 8.6%. Accordi ng to bivariate analysis result, fetal presentation (vertex} , mode of delivery (forceps) , d uratio n of second stage of labor (>120minutes) , peri nial te ar were significantly associated with AI. After controlling the effect of confound ing factors ( variables) , multiple logistic re gression analysis revealed that perineal tear is signi ficantly associated with AI ( AOR ꞊ 7.641; 95% CI (1.443, 40.453 ) P =0.17 , and those mothers had second degree of perinatal tear with ( AOR ꞊ 5.344; CI (1.144, 25.635) P=0.36, had significant association with AI. Conclusion and recommendation: The prevalence of AI at 6 weeks of vaginal delivery was 8.6%. Perineal tear was significantly associated with AI, especially with increasing degree of perineal tear. Thus, it is important to prevent perineal tear. In addition, creating awareness about AI and making integral part of postpartum follow is necessary. | en_US |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/29775 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | Anal incontinence | en_US |
| dc.title | Prevalence of Anal Incontinence Six Weeks After Vaginal Delivery: Prospective Study in the Three Teaching Hospitals in Addis Ababa, Ethiopia | en_US |
| dc.type | Thesis | en_US |