Alteration of anal sphincter function in patients with levator avulsion: observational study

Guedea, María Aubá; Zambrano, Juan Luis Alcázar; Fons, Jorge Baixauli; Viana, Leire Juez; Linaje, Begoña Olartecoechea; Milio, Jose Ángel Mínguez

doi:10.1007/s00192-014-2623-3

Cited by 6 publications

(16 citation statements)

References 32 publications

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“…For this analysis, only studies that reported on the two compared modalities were included. A total of 12 studies involving 1570 women reported on LA following spontaneous delivery and CS at first birth 9,21,24,28,31–33,39,41,44,51,53 . The calculated odds ratio for having an LA following a spontaneous delivery compared with CS was 10.69 (5.44–21.0, I 2 = 0%) (Figure 3, Figure S2).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 23 studies involving 1207 women who were only delivered by CS contributed data for this outcome 9,13,21–25,27,28,31–33,35,39–44,49,51,53,54 . All the studies reported no LAs with the exception of Araujo et al., 43 Guedea et al 32 . and Aydin et al., 35 who reported LA incidence rates of 14, 5 and 40%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies including 796 women contributed to this analysis 9,21,24,29–32,34,39,41,46,47,52 . The pooled incidence rate for LA following vacuum extraction was 0.21 (21%) (0.16–0.27, I 2 = 68%; Figure 2, Figure S1).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 23 studies involving 1207 women who were only delivered by CS contributed data for this outcome. 9,13,[21][22][23][24][25]27,28,[31][32][33]35,[39][40][41][42][43][44]49,51,53,54 All the studies reported no LAs with the exception of Araujo et al, 43 Guedea et al 32 and Aydin et al, 35 who reported LA incidence rates of 14, 5 and 40%, respectively. A meta-analysis of all 23 studies showed an overall incidence rate of 0.03 (3%) (0.00-0.05, I 2 = 66%).…”

Section: Levator Avulsion and Csmentioning

confidence: 99%

“…We identified 23 studies involving a total of 2152 women that assessed LA following the first spontaneous vaginal birth. 9,21,24,28,29,[31][32][33][34]37,39,41,[43][44][45][46][47][48][50][51][52][53]55 The pooled incidence rate of LA in these studies was 0.16 (16%) (0.13-0.19, I 2 = 73%). The highest incidence rate of LA of 0.58 (58%) was reported by Araujo et al, 43 which was much higher than the rates reported by other studies.…”

Section: Levator Avulsion and First Spontaneous Vaginal Deliverymentioning

confidence: 99%

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Levator ani avulsion: a Systematic evidence review (LASER)

Rušavý

Paymova

Kozerovsky³

et al. 2021

BJOG

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Background There is variation in the reported incidence rates of levator avulsion (LA) and paucity of research into its risk factors. Objective To explore the incidence rate of LA by mode of birth, imaging modality, timing of diagnosis and laterality of avulsion. Search strategy We searched MEDLINE, EMBASE, CINAHL, AMED and MIDIRS with no language restriction from inception to April 2019. Study eligibility criteria A study was included if LA was assessed by an imaging modality after the first vaginal birth or caesarean section. Case series and reports were not included. Data collection and analysis RevMan v5.3 was used for the meta‐analyses and SW SAS and STATISTICA packages were used for type and timing of imaging analyses. Results We included 37 primary non‐randomised studies from 17 countries and involving 5594 women. Incidence rates of LA were 1, 15, 21, 38.5 and 52% following caesarean, spontaneous, vacuum, spatula and forceps births, respectively, with no differences by imaging modality. Odds ratio of LA following spontaneous birth versus caesarean section was 10.69. The odds ratios for LA following vacuum and forceps compared with spontaneous birth were 1.66 and 6.32, respectively. LA was more likely to occur unilaterally than bilaterally following spontaneous (P < 0.0001) and vacuum‐assisted (P = 0.0103) births but not forceps. Incidence was higher if assessment was performed in the first 4 weeks postpartum. Conclusions LA incidence rates following caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively. Ultrasound and magnetic resonance imaging were comparable tools for LA diagnosis. Tweetable abstract Levator avulsion incidence rates after caesarean, spontaneous, vacuum and forceps deliveries were 1, 15, 21 and 52%, respectively.

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Section: Resultsmentioning

confidence: 99%