Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study
| العنوان: | Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study |
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| المؤلفون: | Douglas G Tincello, Ash Monga, Joanna C. D’Souza |
| المصدر: | International Urogynecology Journal |
| بيانات النشر: | Springer International Publishing, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Soft Tissue Injuries, Vaginal birth, Urology, Birth weight, 030232 urology & nephrology, Anal Canal, Logistic regression, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Mediolateral episiotomy (MLE), Pregnancy, Medicine, Humans, Advanced maternal age, Perineal trauma, Retrospective Studies, Univariate analysis, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Vaginal delivery, Cesarean Section, Obstetrics and Gynecology, Retrospective cohort study, Odds ratio, Obstetric anal sphincter injuries (OASIS), Middle Aged, Vaginal Birth after Cesarean, United Kingdom, Original Article, Female, business, Vaginal birth after caesarean section (VBAC) |
| الوصف: | Introduction and hypothesis: Vaginal birth after caesarean (VBAC) is associated with an increased risk of obstetric anal sphincter injuries (OASIS). However, specific factors that influence the risk of OASIS at VBAC have not been studied, particularly whether there are specific baseline characteristics of the first delivery which affect the subsequent perineal outcomes. Methods: Retrospective analysis of prospectively collected data from University of Southampton NHS Foundation Trusts’ maternity database. This included secundiparous women with a previous caesarean delivery (CS) who achieved a singleton, term, cephalic vaginal delivery from 2004 to 2014. Univariate analysis compared maternal, intrapartum and neonatal factors of those who suffered OASIS at VBAC with those who did not. A binary logistic regression model calculated the adjusted, independent odds ratio (OR) of OASIS. Results: A total of 1375 women met the inclusion criteria. The OASIS rate was 8.1%, a 1.4-fold increase compared with primiparous women [difference 2.4% (95% CI 1.1, 3.6)]. Those sustaining OASIS at VBAC were older (p = 0.011) and had infants of greater birth weight at initial caesarean (p < 0.001) and VBAC (p = 0.04). Analysis of odds ratios revealed that mediolateral episiotomy (MLE) at VBAC halved the risk of OASIS [37.5% VBAC with OASIS vs. 52.2% VBAC without OASIS (OR 0.51, 95% CI 0.32–0.81)], whereas an urgent CS at initial delivery doubled the risk [52.3% VBAC with OASIS vs. 34.9% VBAC without OASIS (OR 2.05, 95% CI 1.31–3.21)]. Conclusions: Advanced maternal age, increased infant birth weight and an urgent category of initial CS increase the risk of OASIS at VBAC, whereas MLE is protective. |
| وصف الملف: | text |
| اللغة: | English |
| تدمد: | 1433-3023 0937-3462 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f80329cf37330d26339783dd6d285abf http://europepmc.org/articles/PMC6795633 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....f80329cf37330d26339783dd6d285abf |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14333023 09373462 |
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