AI Article Synopsis
- There is growing concern about obstetric anal sphincter injury (OASI), with established risk factors including birthweight and delivery methods like VBAC (vaginal birth after cesarean).
- The objective of the study was to assess whether the prevalence of OASI is higher in women who have experienced a VBAC compared to first-time vaginal delivery (primiparous women).
- The analysis of 23 studies showed that the prevalence of OASI was 8.18% in the VBAC group versus 6.59% in primiparous women, indicating a higher risk for OASI in VBAC cases.
Article Abstract
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 = 98%).
Conclusion: Women undergoing VBAC had a higher prevalence of OASI compared with primiparous women.
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| http://dx.doi.org/10.1111/1471-0528.17227 | DOI Listing |
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