Risk of obstetric anal sphincter injury among women who birth vaginally after a prior caesarean section: A state‐wide cohort study

Uebergang, Jessica; Hiscock, Richard; Hastie, Roxanne; Middleton, Anna; Pritchard, Natasha; Walker, Susan; Tong, Stephen; Lindquist, Anthea

doi:10.1111/1471-0528.17063

Cited by 6 publications

(6 citation statements)

References 39 publications

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“…Studies by Elvander et al (2019) showed that women undergoing vaginal birth after cesarean (VBAC) compared to nulliparous women have an increased risk of severe perineal injury (regardless of the indications and date of the primary cesarean section)-OR = 1.40 [19]. Uebergang et al (2021) also emphasize that women after the first VBAC have a significantly increased risk of third-or fourth-degree perineal injuries compared to primiparous women that had natural labor [20]. The results of our own research are consistent with those presented above.…”

Section: Resultsmentioning

confidence: 99%

“…It should be emphasized that in the literature on the subject, there are numerous reports of spontaneous perineal trauma, in particular, severe perineal trauma. Perineal lacerations of the third and fourth degree are the most severe forms of spontaneous perineal trauma, and at the same time, are associated with numerous negative and long-term consequences for women's health [5,9,[13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Perineal Trauma during Non-Operative Childbirth—Retrospective Analysis of Perineal Laceration Risk Factors

Bączek

Rzońca

Sys

et al. 2022

IJERPH

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Childbirth-related perineal trauma (CRPT) is defined as damage to the skin, muscles of the perineum, as well as to the anal sphincter complex and anal epithelium. The aim of the study was to analyze the risk factors for spontaneous injuries to the soft tissues of the birth canal during non-operative delivery. This was a single-center retrospective case-control study. The study included the analysis of two groups, the study group featured 7238 patients with spontaneous perineal laceration (any degree of perineal laceration) and the control group featured patients without perineal laceration with 7879 cases. The analysis of single-factor logistic regression showed that the factors related to perineal laceration during childbirth are the age of the patients giving birth (p = 0.000), the BMI before delivery (p = 0.000), the number of pregnancies (p = 0.000) and deliveries (p = 0.000), diagnosed gestational diabetes (p = 0.046), home birth (p = 0.000), vaginal birth after cesarean (VBAC) (p = 0.001), the use of oxytocin in the second stage of childbirth (p = 0.041), the duration of the second stage of childbirth (p = 0.000), body weight (p = 0.000), and the circumference of the newborn head (p = 0.000). Independent factors that increase the risk of perineal laceration during childbirth are an older age of the woman giving birth, a history of cesarean section, a higher birth weight of the newborn, and factors that reduce the risk of spontaneous perineal trauma are a higher number of deliveries and home birth.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spontaneous Perineal Trauma during Non-Operative Childbirth—Retrospective Analysis of Perineal Laceration Risk Factors

Bączek

Rzońca

Sys

et al. 2022

IJERPH

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“…73 papers were excluded after abstract reading, either because the abstract was not relevant or because only poster or abstract existed and no full article could be found. During full‐text reading of the remaining 44 articles, 23 were found to be eligible for inclusion in the meta‐analysis 1–10,14–26 . The reasons for excluding 21 articles after full‐text reading were “no primiparous control group”, “VBAC not investigated”, “OASI risk not investigated”, “no numbers on either primiparous or VBAC” or “overlap between studies”.…”

Section: Resultsmentioning

confidence: 99%

“…All included studies provided information on OASI in the primiparous group as well as in the VBAC group. However, in one study VBAC women might have had more than one previous caesarean section 9 and in 11 studies it was not clearly stated if the VBAC women had given birth vaginally before 1,5,10,15,16,18,19,21,24–26 . All studies clearly defined the parity of the women that we use as control group.…”

Section: Resultsmentioning

confidence: 99%

“…During full-text reading of the remaining 44 articles, 23 were found to be eligible for inclusion in the meta-analysis. [1][2][3][4][5][6][7][8][9][10][14][15][16][17][18][19][20][21][22][23][24][25][26] The reasons for excluding 21 articles after full-text reading were "no primiparous control group", "VBAC not investigated", "OASI risk not investigated", "no numbers on either primiparous or VBAC" or "overlap between studies".…”

Section: R E Su Ltsmentioning

confidence: 99%

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Increased risk of obstetric anal sphincter injury in women undergoing vaginal delivery after caesarean section: A systematic review and meta‐analysis

Perslev

Mørch

Jangö

2022

BJOG

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Background: There is increased focus on obstetric anal sphincter injury (OASI) and there are several well-established risk factors such as birthweight, instrumental delivery and median episiotomy. Some studies have found increased risk of OASI in women delivering vaginally after a previous caesarean section (VBAC).Objective: To evaluate whether there is increased prevalence of OASI in VBAC compared with primiparous women.Search strategy: Literature search using PubMed, Embase and Cochrane databases.Selection criteria: All studies with data on both primiparous women and women undergoing VBAC were included. All included studies were evaluated using the "SIGN -methodology checklist" to verify if the quality was acceptable. Data collection and analysis:This systematic review included 23 articles conducted in 11 countries over 19 years. Included studies were analysed using RevMan version 5.4. Main results:We found increased prevalence of OASI in the VBAC group; 8.18% (95% confidence interval [CI] 8.07-8.29) compared with 6.59% (95% CI 6.56-6.62) in primiparous women. Correspondingly, the meta-analysis revealed increased prevalence for OASI in the VBAC group (odds ratio 1.27, 95% CI 1.10-1.47). We found a high level of heterogeneity (I 2 = 98%). Conclusion: Women undergoing VBAC had a higher prevalence of OASI compared with primiparous women.

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Prevention of Perineal Trauma

Okeahialam,

Draycott,

Thakar

2024

Pelvic Floor, Perineal, and Anal Sphincter Trauma During Childbirth

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Risk of obstetric anal sphincter injury among women who birth vaginally after a prior caesarean section: A state‐wide cohort study

Cited by 6 publications

References 39 publications

Spontaneous Perineal Trauma during Non-Operative Childbirth—Retrospective Analysis of Perineal Laceration Risk Factors

Spontaneous Perineal Trauma during Non-Operative Childbirth—Retrospective Analysis of Perineal Laceration Risk Factors

Increased risk of obstetric anal sphincter injury in women undergoing vaginal delivery after caesarean section: A systematic review and meta‐analysis

Prevention of Perineal Trauma

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