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Pregnant, induction with enema, bladder cath. Any anal defect?

hello dr,a primigravida wth normal lab tests n usg reports had a dragging sensation n feeling of acute pressure over the perineal area for many days at 37 wk gestation.On exam head deeply engaged so much very near the introitus, os tightly closed,80% effaced,FHS good.Patient wanted induction to relieve her of cont distress.Induction with enema followed by cstor oil,25mig int vag misoprostol repeated after 8 hrs.contractions mild to moderate but no cervical dilat hardly up to 1 finger tight in 12 to 14hrs.inj epidosin im after 14 still 1 finger tight wth mod to severe ut cont.Suddenly after half an hr head started showing of ,healthy 3 kg f ch del with Rmle.On explo cx still 1 1 finger,large rent in post wall of lower segt,huge bleeding,fast suturing done thro vagina edge to edge,bladder cath, tight vag packing done,iv fluids n strong inj Abs started.vitals normal throughout,pack removed after 36 hrs,no bleedingPV.Pls tel whether any anat defect like pouch,further management, prognosis short term or long term, any advice or warning for future preg.Thanks for the patience to go through.....
Asked On : Sat, 27 Oct 2012
Answers:  1 Views:  45
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OBGYN 's  Response
Thanks for writing to us.
Since your ruptured uterus was repaired, you need to give at least three years gap before planning for next pregnancy. In the next delivery, an elective caesarean section is advisable. You are not likely to have any anal sphincter damage as there is no mention of a vaginal tear.
I hope this information has been both informative and helpful for you.
Dr. Rakhi Tayal
Answered: Fri, 9 Nov 2012
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