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Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists
INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this cho...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606937/ https://www.ncbi.nlm.nih.gov/pubmed/28331968 http://dx.doi.org/10.1007/s00192-017-3304-9 |
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author | Donners, Judith J. A. E. Kluivers, Kirsten B. de Leeuw, Jan W. van Dillen, Jeroen van Kuijk, Sander M. J. Weemhoff, Mirjam |
author_facet | Donners, Judith J. A. E. Kluivers, Kirsten B. de Leeuw, Jan W. van Dillen, Jeroen van Kuijk, Sander M. J. Weemhoff, Mirjam |
author_sort | Donners, Judith J. A. E. |
collection | PubMed |
description | INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this choice and the extent to which this choice is affected by the gynecologist’s characteristics. METHODS: Of 973 gynecologists sent a questionnaire seeking their opinion on the mode of delivery in 16 different case descriptions, 234 (24%) responded. Factors influencing the opinion of the respondents on the mode of delivery, the presence of anal symptoms, the degree of OASI and the characteristics of the respondents were analyzed by univariate and multivariate logistic regression analysis. RESULTS: Recommendations on the mode of delivery in a subsequent pregnancy after OASI showed considerable variation. The recommendations depended on (previous) symptoms and the degree of OASI. For gynecologists who based their recommendations on endoanal ultrasonography outcomes (7–20% depending on the case), the degree of OASI and severity of (previous) symptoms were less important. Gynecologists basing their recommendations on endoanal ultrasonography recommended a primary cesarean section less often. Gynecologist’s characteristics (including years of experience, type of hospital and subspecialty) had a small effect on their recommendations on the mode of delivery. CONCLUSIONS: Due to lack of evidence, recommendations of gynecologists in The Netherlands on the mode of delivery in a subsequent pregnancy after OASI vary widely and depend on (previous) symptoms and the degree of OASI. Gynecologists who based their recommendations on endoanal ultrasonography outcomes recommended cesarean section less often. |
format | Online Article Text |
id | pubmed-5606937 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-56069372017-10-04 Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists Donners, Judith J. A. E. Kluivers, Kirsten B. de Leeuw, Jan W. van Dillen, Jeroen van Kuijk, Sander M. J. Weemhoff, Mirjam Int Urogynecol J Original Article INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this choice and the extent to which this choice is affected by the gynecologist’s characteristics. METHODS: Of 973 gynecologists sent a questionnaire seeking their opinion on the mode of delivery in 16 different case descriptions, 234 (24%) responded. Factors influencing the opinion of the respondents on the mode of delivery, the presence of anal symptoms, the degree of OASI and the characteristics of the respondents were analyzed by univariate and multivariate logistic regression analysis. RESULTS: Recommendations on the mode of delivery in a subsequent pregnancy after OASI showed considerable variation. The recommendations depended on (previous) symptoms and the degree of OASI. For gynecologists who based their recommendations on endoanal ultrasonography outcomes (7–20% depending on the case), the degree of OASI and severity of (previous) symptoms were less important. Gynecologists basing their recommendations on endoanal ultrasonography recommended a primary cesarean section less often. Gynecologist’s characteristics (including years of experience, type of hospital and subspecialty) had a small effect on their recommendations on the mode of delivery. CONCLUSIONS: Due to lack of evidence, recommendations of gynecologists in The Netherlands on the mode of delivery in a subsequent pregnancy after OASI vary widely and depend on (previous) symptoms and the degree of OASI. Gynecologists who based their recommendations on endoanal ultrasonography outcomes recommended cesarean section less often. Springer London 2017-03-22 2017 /pmc/articles/PMC5606937/ /pubmed/28331968 http://dx.doi.org/10.1007/s00192-017-3304-9 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Donners, Judith J. A. E. Kluivers, Kirsten B. de Leeuw, Jan W. van Dillen, Jeroen van Kuijk, Sander M. J. Weemhoff, Mirjam Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title | Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title_full | Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title_fullStr | Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title_full_unstemmed | Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title_short | Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists |
title_sort | choice of mode of delivery in a subsequent pregnancy after oasi: a survey among dutch gynecologists |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606937/ https://www.ncbi.nlm.nih.gov/pubmed/28331968 http://dx.doi.org/10.1007/s00192-017-3304-9 |
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