Preventing Anal Sphincter Tears During Delivery. An Update from Scandinavia

Gynecology and Womens Health

A common outcome of vaginal delivery is perineal trauma. The most serious among these injuries are third- and fourthdegree lacerations or obstetric anal sphincter injuries. Studies have reported that 30–50% of women with these lacerations experience anal incontinence. Symptoms of anal incontinence may affect a woman’s social, psychological, and sexual life; moreover, a previous anal sphincter injury can increase the risk of recurrence in subsequent deliveries. Therefore, it is important to prevent these injuries.

The frequency of anal sphincter injuries varies a lot between countries in Europe. The highest rates are being reported from Switzerland, Iceland, Sweden and Denmark, and a frequency counting to 6 % of all vaginal deliveries is reported. The lowest rates are usually found in Eastern Europe, Israel, Italy, and Finland where the tear rates have been below 1 % but even close to 0.5 %.

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