Currently, guidelines from the Royal College of Obstetricians and Gynaecologists stipulate that all women who have sustained an obstetric anal sphincter injury in a previous pregnancy and who are symptomatic or have abnormal endoanal ultrasonography and/ or manometry should be counselled regarding the option of an elective Caesarean section. An abnormal endoanal ultrasonography is currently considered to be a defect of the external anal sphincter (EAS) of more than 30 degrees while an abnormal anorectal manometry would be an incremental squeeze pressure of less than 20mmHg. This study aims to evaluate if a course of guided pelvic floor exercises could improve anal sphincter function on those with suboptimal or abnormal anal incremental squeeze pressures, and subsequently expand their options for future modes of delivery (vaginal delivery not contraindicated)
Study Type
OBSERVATIONAL
Enrollment
50
4 months of supervised physiotherapy by a women's health physiotherapists (3 sessions in total)
Kings College Hospital
London, United Kingdom
RECRUITINGSuccess
1. Change of incremental squeeze pressure from abnormal (\<20mmHg) or suboptimal (20-40mmHg) to normal (\>40mmHg) 2. Change of incremental squeeze pressure from abnormal (\<20mmHg) to suboptimal (20-40mmHg)
Time frame: 4 months
Change or recommended mode of delivery
Change of recommended mode of delivery from elective Caesarean section only to spontaneous vaginal delivery or elective Caesarean section
Time frame: 4 months
Change in St Mark's Score
Change in St Mark's score before and after intervention
Time frame: 4 months
Change in International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form (ICIQ-UI SF)
Change in ICIQ-UI SF before and after intervention
Time frame: 4 months
Change in Faecal Incontinence Quality of life Scale
Change in Faecal Incontinence Quality of life Scale before and after intervention
Time frame: 4 months
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