Using the Brink score to predict postpartum anal incontinence

Am J Obstet Gynecol. 2010 Nov;203(5):486.e1-5. doi: 10.1016/j.ajog.2010.07.032. Epub 2010 Sep 17.

Abstract

Objective: To evaluate whether antepartum pelvic floor muscle strength, as measured by the Brink scale, predicts postpartum anal incontinence.

Study design: This prospective cohort study of primigravid women used validated questionnaires and standardized pelvic examinations to evaluate subjects during the third trimester and at 2 postpartum time points.

Results: Of the initial 129 subjects, 102 and 81 completed 2 week and 6 month postpartum visits. 35% had cesarean deliveries. The antepartum prevalence of fecal incontinence (14%) did not differ significantly from the postpartum (17% at 2 weeks, 11% at 6 months). However, the prevalence of flatal incontinence fell from antepartum (65%) to postpartum (47% at 2 weeks, P = .001; 49% at 6 months, P = .012). Mean Brink score decreased postpartum; no correlations were found between Brink score and questionnaire scores.

Conclusion: Anal incontinence symptoms are common in the third trimester of a first pregnancy and may regress or resolve after delivery. Brink score did not predict postpartum anal incontinence.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Fecal Incontinence / physiopathology*
  • Female
  • Humans
  • Pelvic Floor / physiopathology*
  • Postpartum Period*
  • Predictive Value of Tests*
  • Pregnancy
  • Pregnancy Complications / physiopathology
  • Pregnancy Trimester, Third
  • Prospective Studies
  • Puerperal Disorders / physiopathology*
  • Surveys and Questionnaires