influence of breech delivery on the anal sphincter and faecal incontinence

ABSTRACT

One hundred and twenty five pregnant women were included. They were divided into three groups Group I included patients with cephalic presentation, group II included patients with breech presentation and a plan for elective cesarean section and group III included patients with breech presentation and a plan for vaginal delivery. Antenatal anal ultrasonography was done, and those with anal sphincter injury were excluded. Also, patients who underwent emergency cesarean section were excluded. Post-natal, anal ultrasonography and a clinical interview were performed to find out those with anal sphincter injury and/or anal incontinence. Sixty patients were included in the final analysis, 20 in each group. There were two cases of anal sphincter injury in the cephalic group, none in the cesarean section group and nine in the breech vaginal delivery group. There was one case of fecal incontinence in the cephalic group, none in the cesarean section group, and nine in the breech vaginal delivery group. All those differences were statistically significant. Vaginal breech delivery is associated with a significantly higher incidence of anal sphincter injury and fecal incontinence in comparison with both vaginal cephalic delivery and cesarean section for breech presentation