The manometric evaluation of the effect of normal spontaneous vaginal delivery and cesarean delivery on the anal sphincter and the relationship between perineal lenght and anal sphincter injury

Objective: The aim of the study is define anal sphincter function in patients after normal spontaneous vaginal delivery and cesarean delivery by evaluating antepartum and postpartum anal manometric measurements, then comparing these results with each patients perineal length. Design: This study is a clinical study. Setting: The study was performed at Gazi University Medicine Faculty Department of Obstetrics and Gynecology and Gastroenterology clinics. Participants: One hundred twenty pregnant patients were included in this study. Intervention: Anal manometric measurements were performed on all patients in both the antepartum and postpartum period and evaluation perineal lenght. Main Outcome Measures: Antepartum and postpartum anal manometric values were compared. As a result, patients who had undergone normal spontaneous vaginal delivery or a cesarean delivery did not show significantly reduced Maximum Anal Resting Pressure (MARP) and Maksimum Anal Squeeze Pressure (MASP) values. The patients postpartum MASP values showed a positive correlation with perineal length (r=0.239, p<0.01). Results: When patients who had normal spontaneous vaginal delivery and a cesarean delivery had their anal manometric measurements compared, we came to the conclusion that delivery with a cesarean delivery proved more beneficial when considering anal sphincter function. Besides this, perineal length also seems to have a protective effect on sphincter function.