Influence of the subpubic arch angle on anal sphincter @entity130 and anal XXXX following childbirth.

@entity1 @entity1162 @entity322 @entity130
OBJECTIVE: To assess the relationship between the subpubic arch angle, anal sphincter and perineal @entity130 , and anal @entity322 after childbirth in nulliparous @entity1 . DESIGN: Prospective cohort study. SETTING: University teaching hospital. SAMPLE: One hundred thirty-four low risk nulliparous @entity1 . METHODS: Measurements of the bony pelvic outlet were made to calculate the subpubic arch angle. Endosonographic assessment of the perineum and anal sphincter was made before and after delivery. A specific bowel function questionnaire was completed before and after delivery. MAIN OUTCOME MEASURES: Perineal and anal sphincter @entity130 , and deteriorating anal continence after delivery. RESULTS: Thirty-two @entity1 with a subpubic arch angle of less than 90 degrees had significantly prolonged first and second stages of labour when compared with 102 @entity1 whose subpubic arch was wider. Following delivery, anal continence deteriorated in more @entity1 with a narrow subpubic angle (69% vs 21%, P < 0.001) but this was unrelated to the incidence of anal sphincter and perineal @entity130 . CONCLUSIONS: A narrow subpubic arch is strongly associated with @entity1162 and postpartum anal @entity322 in nulliparous @entity1 . However, perineal and anal sphincter @entity130 , assessed by ultrasound, does not account for the higher rate of postpartum analincontinence in @entity1 with a narrow subpubic arch angle.
