Anal sphincter rupture during vaginal delivery

Rupture of the anal sphincter during childbirth is a major cause of faecal incontinence among women, a condition with considerable psychosocial consequences. The reported incidences show large variations, from 0.36% to 24%. Definitions and classifications vary as much. Also, reports on the persisting subjective problems of the women afflicted demonstrate diversity. Over a 2(1/2) year period from January 2000, all women with partial or total rupture of the anal sphincter during delivery were invited to a follow up consultation after 6 months and interviewed about their subjective discomfort. Over the period in question we registered 147 ruptures of the anal sphincter among 6124 vaginal deliveries (2.4%); 109 (1.7%) were partial ruptures, 38 (0.7%) total ruptures. Among the 137 women who came in for a consultation 6 months after delivery, 92 (67%) had no complaints at all. Five women (4%) had some degree of leakage for liquid stools. None of them had incontinence for solid stools. The reported incidence is in keeping with most of the previous registrations in the Nordic countries, but not with those giving the lowest figures. Improved delivery technique might reduce the incidence. The incidence of discomfort and complaints we found at 6 months was lower than expected on the basis of previous reports.