Anal Sphincter Damage After Vaginal Delivery Using Three-Dimensional Endosonography

The Effectiveness of Red Betel Leaf and Cinnamon Oil for Antibacterial and Anti-inflammatory in Perineal Tears: A Scoping Review

BACKGROUND: A tear in the perineum experienced by postpartum women can occur due to an episiotomy process or a spontaneous tear. This cloak, in addition to causing curiosity, can also cause infection if not treated or treated appropriately. Based on several research results, the current treatment for perineal tears is the administration of antiseptic, anti-pain, and antibiotics orally or topically. Several Indonesian herbal plants can be used to accelerate the healing of torn wounds in the perineum due to the ability of these plants as antibacterial and anti-inflammatory. These plants include red betel leaf and cinnamon oil. AIM: The objective of the study was to review the literature from research results that discuss the activity of red betel leaf and cinnamon oil as antibacterial and anti-inflammatory both orally and topically. SEARCH METHOD: Searching for articles through databases on Google Scholar, in the past years, that is, 2008–2021. INCLUSION: Review articles involving research on experimental animals with in vitro and in vivo activity tests using the Completely Randomized Design method. RESULTS: As well as, 12 relevant articles showed that both red betel leaf and cinnamon oil were tested in vitro and in vivo, showing that these two plants effectively act as antibacterial and anti-inflammatory. CONCLUSION: Two herbal plants red betel leaf and cinnamon oil have the potential to treat and accelerate the healing of perineal tears through their antibacterial and anti-inflammatory activities.

Quality of life and 3D-EUS assessment for anal incontinence after childbirth

BACKGROUND

the incidence of obstetric sphincter tears has risen to 15-30% and the prevalence of anal incontinence (AI) symptoms after childbirth may be as high as 40%. The present study evaluates the correlation between obstetric injuries detected by endoanal ultrasound (3D-EUS) and AI symptoms, as well as their impact on the quality of life (QOL) of women after childbirth.

METHODS

a prospective observational study was performed of pregnant women evaluated before (baseline) and three months after childbirth to ensure the integrity of the anal sphincters and to evaluate possible injuries. The Fecal Incontinence Quality of Life (FIQL) questionnaire and the Cleveland Clinic Score of Incontinence (Wexner) were completed before and after childbirth. The questionnaire results were correlated with an assessment of sphincter defects performed by 3D-EUS.

RESULTS

a total of 56 females were included in the study. Overall, 48% developed symptoms of AI after childbirth, with a significant decrease in their FIQL compared to the initial evaluation, 3.9 (0.05) vs 3.4 (0.8), respectively (p = 0.000). In addition, 42% of the cohort presented with some kind of obstetric sphincter defect on the 3D-EUS. Instrumental assisted delivery and the sphincter defects were the only two significant factors identified via multivariate analysis that were associated with a decrease in QOL (0.4, 95% CI, 0.07-0.8).

CONCLUSIONS

AI after childbirth was associated with a huge impact on QOL, especially in patients with sphincter injuries. A complete clinical evaluation, including 3D-EUS, is recommended to prevent, manage or treat AI in primiparous females.