E-Posters-5 Year Review of Functional Outcome Following 4th Degree Perineal Tear Repair and Subsequent Mode of Delivery Decision Model

5 Year Review of Functional Outcome Following 4th Degree Perineal Tear Repair and Subsequent Mode of Delivery Decision Model - Shane Bandara

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Pdf Summary

This study aimed to evaluate the St Marks incontinence scoring system as a tool for guiding mode of delivery in pregnancies following a 4th degree tear, as well as assessing the mid-term functional outcome following primary repair. Data was collected from patients who experienced a 4th degree tear at a District General Hospital between January 2013 and December 2017. The postnatal St Marks Incontinence Score was noted for each patient, and for those with subsequent pregnancies, the antenatal St Marks Incontinence score and mode of delivery were obtained. Patients were contacted via telephone to assess their current St Marks Incontinence score. <br /><br />Of the 24 patients who suffered a 4th degree tear, complete data was obtained for 17 patients. The initial postnatal St Marks Incontinence score was performed an average of 15 weeks after delivery, with scores ranging from 0 to 15. <br /><br />Out of the 17 patients, 7 had subsequent deliveries. Of these, 4 patients had a St Marks Incontinence Score performed during their subsequent pregnancy. One patient with a score of 6 had a C-section, while three patients with an antenatal score of 0 had a normal vaginal delivery. The remaining three patients were managed by an Obstetrician in general antenatal clinic, and all had a C-section. <br /><br />At an average of 3 years and 8 months after the initial injury, 94% of patients had a normal St Marks Incontinence score, with no worsening of their symptoms. Women who had a vaginal delivery showed no deterioration in their symptoms mid-term. <br /><br />While the sample size is small, this study suggests that the St Marks Incontinence scoring system may be a useful tool in the antenatal counselling process to determine the mode of subsequent delivery in units without access to certain diagnostic tools. Overall, the functional outcome following primary repair in this unit was excellent.

Keywords

St Marks incontinence scoring system

mode of delivery

pregnancies

4th degree tear

functional outcome

primary repair

District General Hospital

postnatal St Marks Incontinence Score

antenatal St Marks Incontinence score

telephone assessment