Increased risk of obstetric anal sphincter injury in women undergoing vaginal delivery after caesarean section: A systematic review and meta-analysis
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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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, Kathrine; Mørch, Ella Josephine; Jangö, Hanna.
I: BJOG: An International Journal of Obstetrics and Gynaecology, Bind 129, Nr. 12, 2022, s. 1961-1968.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Increased risk of obstetric anal sphincter injury in women undergoing vaginal delivery after caesarean section
T2 - A systematic review and meta-analysis
AU - Perslev, Kathrine
AU - Mørch, Ella Josephine
AU - Jangö, Hanna
N1 - Publisher Copyright: © 2022 John Wiley & Sons Ltd.
PY - 2022
Y1 - 2022
N2 - 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 (I2 = 98%). Conclusion: Women undergoing VBAC had a higher prevalence of OASI compared with primiparous women.
AB - 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 (I2 = 98%). Conclusion: Women undergoing VBAC had a higher prevalence of OASI compared with primiparous women.
KW - caesarean section
KW - obstetric anal sphincter injury
KW - sphincter
KW - vaginal birth after previous caesarean section
KW - vaginal delivery
U2 - 10.1111/1471-0528.17227
DO - 10.1111/1471-0528.17227
M3 - Review
C2 - 35596697
AN - SCOPUS:85131802722
VL - 129
SP - 1961
EP - 1968
JO - British Journal of Obstetrics and Gynaecology, Supplement
JF - British Journal of Obstetrics and Gynaecology, Supplement
SN - 0140-7686
IS - 12
ER -
ID: 320107121