Abstract：
BACKGROUND: Obstetric anal sphincter injury is a complication of vaginal delivery, if left untreated, causes significant maternal morbidities; urinary problems and fecal/ flatus incontinence. The aim of this study was to determine the incidence and describe the obstetric characteristics and functional outcomes of women who had vaginal delivery at Paropakar Maternity and Women\'s Hospital Nepal and sustained Obstetric anal sphincter injury.
METHODS: This retrospective descriptive study included women who had vaginal delivery, irrespective of parity, in the labor room or birthing unit of Paropakar Maternity and Women\'s Hospital from April 2018 to September 2020, and sustained Grade III or IV Obstetric anal sphincter injury after 28 weeks period of gestation. Maternal characteristics, obstetric details and perineal status after vaginal delivery were noted after review of hospital records. The patients were further inquired via telephone for their current status of fecal and/or urinary incontinence.
RESULTS: The incidence of OASI was 106 (0.33%) among 31, 786 Nepalese women with vaginal birth over a 2-year period. The mean age women with Obstetric anal sphincter injury was 24.6 ± 4.3 years and 45(52.9%) cases belonged to Janajati ethnicity. Fifty two (61.2 %) were primipara and 77 (90.6%) had spontaneous vaginal deliveries. Episiotomy was not performed on most of the patients (63, 74.1%). Problems with flatus holding, stool holding and urine holding was reported by 28.3%, 13.2% and 22.6% women respectively.
CONCLUSIONS: The incidence of Obstetric anal sphincter injury among Nepalese women with vaginal birth over a 2-year period was 0.33%, which was lower than other South Asian studies. Grade III Obstetric anal sphincter injury was the frequent most type. The injuries were more common in women with Janajati ethnicity, primipara and women who did not have episiotomy. Problems with flatus holding and urine holding were present in almost one-fourth of the women with Obstetric anal sphincter injury at follow up.
METHODS: This retrospective descriptive study included women who had vaginal delivery, irrespective of parity, in the labor room or birthing unit of Paropakar Maternity and Women\'s Hospital from April 2018 to September 2020, and sustained Grade III or IV Obstetric anal sphincter injury after 28 weeks period of gestation. Maternal characteristics, obstetric details and perineal status after vaginal delivery were noted after review of hospital records. The patients were further inquired via telephone for their current status of fecal and/or urinary incontinence.
RESULTS: The incidence of OASI was 106 (0.33%) among 31, 786 Nepalese women with vaginal birth over a 2-year period. The mean age women with Obstetric anal sphincter injury was 24.6 ± 4.3 years and 45(52.9%) cases belonged to Janajati ethnicity. Fifty two (61.2 %) were primipara and 77 (90.6%) had spontaneous vaginal deliveries. Episiotomy was not performed on most of the patients (63, 74.1%). Problems with flatus holding, stool holding and urine holding was reported by 28.3%, 13.2% and 22.6% women respectively.
CONCLUSIONS: The incidence of Obstetric anal sphincter injury among Nepalese women with vaginal birth over a 2-year period was 0.33%, which was lower than other South Asian studies. Grade III Obstetric anal sphincter injury was the frequent most type. The injuries were more common in women with Janajati ethnicity, primipara and women who did not have episiotomy. Problems with flatus holding and urine holding were present in almost one-fourth of the women with Obstetric anal sphincter injury at follow up.
摘要：
背景：产科肛门括约肌损伤是阴道分娩的并发症，如果不及时治疗，导致严重的产妇发病率；排尿问题和大便/排气失禁。这项研究的目的是确定在尼泊尔Paropakar妇产医院阴道分娩并持续产科肛门括约肌损伤的妇女的发病率并描述其产科特征和功能结局。
方法：这项回顾性描述性研究包括阴道分娩的妇女，不管平价，2018年4月至2020年9月期间，在Paropakar妇产医院的产房或分娩室，妊娠28周后持续III或IV级产科肛门括约肌损伤。产妇特征,在检查医院记录后,记录阴道分娩后的产科细节和会阴状态.通过电话进一步询问患者的粪便和/或尿失禁的现状。
结果：在过去2年的31,786名尼泊尔阴道分娩妇女中，OASI的发生率为106（0.33％）。产科肛门括约肌损伤的平均年龄为24.6±4.3岁，其中45例（52.9％）属于Janajati种族。初产妇52例（61.2％），自然阴道分娩77例（90.6％）。大多数患者未进行会阴切开术（63，74.1％）。肠胃外有问题，报告有28.3%的大便和尿，女性分别为13.2%和22.6%。
结论：尼泊尔阴道分娩妇女中产科肛门括约肌损伤的发生率为0.33%，低于其他南亚研究。III级产科肛门括约肌损伤是最常见的类型。受伤在Janajati种族的女性中更为常见，初产妇和未进行会阴切开术的妇女。在随访中，近四分之一的产科肛门括约肌损伤妇女存在肠胃胀气和排尿问题。
方法：这项回顾性描述性研究包括阴道分娩的妇女，不管平价，2018年4月至2020年9月期间，在Paropakar妇产医院的产房或分娩室，妊娠28周后持续III或IV级产科肛门括约肌损伤。产妇特征,在检查医院记录后,记录阴道分娩后的产科细节和会阴状态.通过电话进一步询问患者的粪便和/或尿失禁的现状。
结果：在过去2年的31,786名尼泊尔阴道分娩妇女中，OASI的发生率为106（0.33％）。产科肛门括约肌损伤的平均年龄为24.6±4.3岁，其中45例（52.9％）属于Janajati种族。初产妇52例（61.2％），自然阴道分娩77例（90.6％）。大多数患者未进行会阴切开术（63，74.1％）。肠胃外有问题，报告有28.3%的大便和尿，女性分别为13.2%和22.6%。
结论：尼泊尔阴道分娩妇女中产科肛门括约肌损伤的发生率为0.33%，低于其他南亚研究。III级产科肛门括约肌损伤是最常见的类型。受伤在Janajati种族的女性中更为常见，初产妇和未进行会阴切开术的妇女。在随访中，近四分之一的产科肛门括约肌损伤妇女存在肠胃胀气和排尿问题。
