Factors affecting failed trial of labor and countermeasures: A retrospective analysis

Wang, Jinguang; Sun, Jingli; Shen, Jian

doi:10.12998/wjcc.v8.i16.3483

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…16 Our series included all patients who had undergone a cesarean section, whether electively, or as the result of an emergency after the failure of an attempt at vaginal delivery, which is reported to occur at a rate of approximately 10%. 17 The number of each type of cesarean in each group may result in a bias, because there is no way to differentiate the two indications. Our hypothesis is that cesarean section is associated with a higher rate of severe anal incontinence because of the failure of vaginal delivery.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, cesarean sections are reported to reduce the risk of anal incontinence 16 . Our series included all patients who had undergone a cesarean section, whether electively, or as the result of an emergency after the failure of an attempt at vaginal delivery, which is reported to occur at a rate of approximately 10% 17 . The number of each type of cesarean in each group may result in a bias, because there is no way to differentiate the two indications.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, cesarean sections probably protect against OASIS and severe anal incontinence. However, they may also be performed because of complications during vaginal delivery (1/8) 17 and this may therefore increase the risk OASIS and severe anal incontinence.…”

Section: Discussionmentioning

confidence: 99%

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Obstetrical anal sphincter injury and unnecessary episiotomy are both associated with anal incontinence 8 years after childbirth: A nationwide database analysis

Levaillant

Legendre

Rebmann

et al. 2022

Intl J Gynecology & Obste

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Objective To assess the relationship between anal incontinence (AI) 8 years after childbirth and the occurrence of obstetrical anal sphincter injuries (OASIS) and/or performance of an episiotomy during childbirth. Methods This is a nationwide database analysis performed on two national medico‐administrative databases, including all the women aged 18 years or older who delivered infants in France in 2012. The main outcome measure was AI in the 8 years after delivery. Results Of the 163 443 perineal tears reported, 0.47% were grade 3 (n = 3173) and 0.08% were grade 4 (n = 579); 8938 women experienced AI (1.33%) and 261 women experienced severe AI (0.04%). Episiotomies performed in the absence of risk factors for OASIS were significantly associated with an increased risk of AI (odds ratio [OR] 1.59, 95% confidence interval [CI]1.49–1.69; P < 0.001). Grade 3 and 4 OASIS also significantly increased the risk of AI and severe AI. Mediolateral episiotomy was preventive of OASIS when performed in women at risk (OR 0.26, 95% CI 0.23–0.30; P < 0.001) but contributed to OASIS in the absence of risk (OR 2.18, 95% CI 1.98–2.40; P < 0.001). Conclusion OASIS present a risk factor for AI. Episiotomies could reduce the occurrence of OASIS, but they could also increase the risk of long‐term AI in the absence of risk factors for OASIS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Obstetrical anal sphincter injury and unnecessary episiotomy are both associated with anal incontinence 8 years after childbirth: A nationwide database analysis

Levaillant

Legendre

Rebmann

et al. 2022

Intl J Gynecology & Obste

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“…As vaginal delivery is associated with many uncertain factors, advanced pregnant women are more prone to surgical intervention, increasing the CS rate. Kim et al showed advanced maternal age is an independent risk factor of emergency CS due to a non-reassuring fetal heart rate or arrest disorder ( 29 ), and a previous study revealed it as an independent risk factor associated with conversion to an emergency CS post failed trial labor ( 30 ). Additionally, Attali et al reported that advanced maternal age is an independent risk factor for intrapartum CS ( 15 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of maternal age and duration of labor on perinatal and neonatal outcomes: a retrospective cohort study

Shen¹,

Song²,

Zeng³

et al. 2022

Ann Transl Med

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Background: This study aimed to investigate the effect of maternal age and duration of labor on perinatal and neonatal outcomes. The results of this study are expected to provide a basis to aid maternal and child health care personnel to implement health education for late childbearing women.Methods: This was a retrospective observational study, wherein 9,241 parturients were included from 2016 to 2018. Parturients were divided into three groups based on age: <28 (n=2,911), 28-30 (n=3,631), and >30 (n=2,699) years. According to the total duration of labor, those who did not undergo cesarean section (CS) were subgrouped into <420 minutes (n=4,065) and ≥420 minutes (n=4,094) groups. A multivariate logistic regression model was used to investigate associations between age/total duration of labor group factors to different postpartum outcomes, including a switch to emergency CS, puerperal morbidity, abnormal fetal heart rate, and meconium-stained amniotic fluid (MSAF). Results:The rates of postpartum outcomes significantly differed in maternal age groups, including switch to emergency CS (9.07% vs. 13.03% vs. 11.23%; P<0.001), puerperal morbidity (6.32% vs. 6.46% vs. 5.00%; P=0.035), and abnormal fetal heart rate (25.34% vs. 28.21% vs. 25.67%; P=0.017). Of the comparisons between labor time groups, it was found that participants with longer labor time were also significantly higher in the use of episiotomy/forceps (46.61% vs. 69.77%; P<0.001), bleeding amount (381.35±108.02 vs. 389.60±146.40 mL; P=0.004), oxytocin use (25.03% vs. 39.56%; P<0.001), puerperal morbidity (1.98% vs. 6.86%; P<0.001), abnormal fetal heart rate (20.07% vs. 25.15%; P<0.001), and MSAF (26.53% vs. 31.91%; P<0.001). Multivariate logistic regression analysis showed that as age increased, the ORs of switching to emergency CS (1.58 and 1.87, both P<0.001) and having abnormal fetal heart rate (1.20 and 1.38; both P<0.01) also increased. Participants with longer labor time groups the ORs of puerperal morbidity (2.33; P<0.001) and MSAF (1.13; P=0.023) also increased.Conclusions: With the adjustment of covariates. Higher maternal age seems associated to the risk of switching to emergency CS and having abnormal fetal heart rate; longer total duration of labor seems associated to the risk of puerperal morbidity and MSAF.

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“…In patients with PPP, the median intraoperative blood loss is approximately 2,000 mL during delivery, and in 10% of patients, it has reportedly exceeded 10,000 mL [1][2][3] . In recent years, the incidence of PPP has risen with the increasing rate of cesarean deliveries [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Ability to track hemodynamic changes in parturients undergoing cesarean section using central venous pressure, stroke volume, and stroke volume variation: a prospective observational study

Zhang

Liu

et al. 2022

Preprint

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Fluid management in parturients with massive bleeding is often difficult to gauge because there are no reliable indicators of the fluid status. Thirty-two eligible parturients with pernicious placenta previa at the Qilu Hospital of Shandong University between January 2019 and August 2021 were included in this prospective observational study. All subjects were monitored continuously to measure the central venous pressure (CVP), stroke volume (SV), and stroke volume variation (SVV) along with standard monitoring. The primary outcome is the sensitivity and specificity of HR, CVP, SV, and SVV to diagnose hemodynamic instability induced by massive blood loss, which was evaluated by receiver operating characteristic (ROC) curve analysis. The areas under the ROC curve for HR, CVP, SVV, and SV to diagnose hemodynamic instability were 0.83 (sensitivity: 0.62, specificity: 1), 0.79 (sensitivity: 0.46, specificity: 1), 0.72 (sensitivity: 0.62, specificity: 0.95), and 0.64 (sensitivity: 0.69, specificity: 0.68), respectively. Massive blood loss, general anaesthesia induction, and balloon deflation caused significant changes in corresponding hemodynamic indicators. The CVP, SV, and SVV can effectively track the hemodynamic changes in parturients undergoing cesarean section. The sensitivity is low and the specificity is high for HR, CVP, and SVV to diagnose massive blood loss-induced hemodynamic instability.

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Factors affecting failed trial of labor and countermeasures: A retrospective analysis

Cited by 6 publications

References 26 publications

Obstetrical anal sphincter injury and unnecessary episiotomy are both associated with anal incontinence 8 years after childbirth: A nationwide database analysis

Obstetrical anal sphincter injury and unnecessary episiotomy are both associated with anal incontinence 8 years after childbirth: A nationwide database analysis

The effect of maternal age and duration of labor on perinatal and neonatal outcomes: a retrospective cohort study

Ability to track hemodynamic changes in parturients undergoing cesarean section using central venous pressure, stroke volume, and stroke volume variation: a prospective observational study

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