Up to 40% of vaginal deliveries lead to pelvic floor denervation. This has been linked causally with the later occurrence of urinary incontinence, faecal incontinence and vaginal prolapse. Pelvic floor position, anal sphincter pressures and anal electrosensitivity were evaluated in 72 volunteers as simple screening tests for detecting patients who might benefit from neurological assessment. A lower perineum and reduced voluntary sphincter pressures were found antenatally in parous women when compared with nulliparas. The tests were repeated postnatally 24 to 72 hours after delivery. When compared with antenatal readings, the perineum was lower and sphincter pressures were reduced in subjects delivered vaginally. Forty one subjects were reexamined after 6-8 weeks and partial recovery was found. Anal squeeze pressures and pelvic floor position when straining were the results most consistently changed. On the basis of this study it is suggested that 28% of multiparas seen anrenatally and between 25% to 30% of all women who deliver vaginally may be eligible for more detailed neurological study.
Background-Recently interest in idiopathic (neurogenic) faecal incontinence has swung from denervation ofthe external anal sphincter to the internal sphincter. Aims-To evaluate the eiffects of vaginal delivery on the internal sphincter. Subjects-1372 mothers were studied antenatally and 1202 were accepted into the study. Methods-Sphincter pressures were
SUMMARY Accidental intra-arterial injection of intramuscular antibiotic preparations is described in 3 cases in infants. In 2 benzathine penicillin was injected, and in 1 rolitetracycline. The clinical features are dominated by arteriolar obstruction which produces gangrene of the most severely affected limb. In addition, neurological involvement occurs when vessels to nerves or spinal cord are involved. The anterolateral aspect of the thigh is preferable to the buttock as a site for intramuscular injection, and a short (2.5 cm) needle should be used to minimise the risk of intra-arterial injection.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.