Clinical study of anal sphincter training combined with manual protection to reduce the risk of obstetric anal sphincter rupture.
10.3760/cma.j.issn.1672-7088.2019.17.007
- VernacularTitle: 肛门括约肌训练联合手动保护降低产科肛门括约肌破裂风险的临床研究
- Author:
Zheng YUAN
1
;
Ying LU
2
;
Tiange SUN
2
;
Bing CHAI
3
Author Information
1. Nursing Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
2. Obstetrics Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
3. the First Area of Ophthalmology, Third Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
- Publication Type:Clinical Trail
- Keywords:
Sphincter exercise;
Obstetrics;
Primiparity;
Sphincter laceration
- From:
Chinese Journal of Practical Nursing
2019;35(17):1307-1311
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of anal sphincter training combined with manual protection to reduce the risk of obstetric anal sphincter rupture.
Methods:Totally 720 primipara were randomly divided into two groups by random number table method, with 360 cases in each group. The control group was given manual protection during midwifery. The observation group was given anal sphincter training before delivery and manual protection during midwifery. Postpartum anal pressure (anal resting pressure, anal systolic pressure), rectal pressure (rectal resting pressure, rectal defecation pressure) were measured. The incidence of postpartum anal incontinence (gas incontinence, liquid fecal incontinence, and solid fecal incontinence), defecation (urgent defecation, anal pain during defecation, pushing rectal defecation, protrusion of anal canal after defecation) and rupture of anal sphincter were recorded.
Results:Postpartum rectal resting pressure and rectal defecation pressure were (4.50±0.44) and (65.41±10.66) mmHg (1 mmHg=0.133 kPa) in the observation group and (5.68±0.61) and (56.75±9.83) mmHg in the control group, respectively. There were significant differences between the two groups (t=6.011, 8.027, P<0.01). The incidence of postpartum gas incontinence, liquid fecal incontinence and solid fecal incontinence were 2.22% (8/360), 0.56% (2/360) and 0.56% (2/360) respectively in the control group and 0.56% (2/360) in the observation group. The incidence of postpartum gas incontinence, liquid fecal incontinence and solid fecal incontinence were 0.56% (2/360), 0.27% (1/360) and 0.27% (1/360), respectively. There were significant differences between the two groups (χ2=4.120, P<0.05). The incidences of postpartum urgency, anal pain, pushing and pressing rectal defecation and anal canal prolapse were 3.33% (12/360), 3.89% (14/360), 3.89% (14/360), 3.89% (14/360), 1.11% (4/360) in the control group and 1.67% (6/360), 2.22% (8/360), 1.67% (6/360) and 0.56% (2/360) in the observation group, respectively (χ2=5.101, P<0.01). The incidence of rupture of anal sphincter was 0.56% (2/360) in the observation group and 3.33% (12/360) in the control group. There was significant difference between the two groups (χ2=5.887, P<0.05).
Conclusion:Anterior anal sphincter training combined with manual protection during midwifery can effectively reduce the risk of anal sphincter rupture and protect the rectal and anal functions of pregnant women.
