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Influence of previous delivery mode on perineal trauma risk

OBJECTIVE: To evaluate the impact of a previous pregnancy and delivery on perineal trauma rates in the subsequent vaginal birth. METHODS: Retrospective cohort study. The perineal outcomes of secundiparous women with history of previous (first) delivery in one of three categories: failed operative va...

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Autores principales: Thorne, Elizabeth P. C., Durnea, Constantin M., Sedgwick, Philip M., Doumouchtsis, Stergios K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790575/
https://www.ncbi.nlm.nih.gov/pubmed/35426118
http://dx.doi.org/10.1002/ijgo.14218
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author Thorne, Elizabeth P. C.
Durnea, Constantin M.
Sedgwick, Philip M.
Doumouchtsis, Stergios K.
author_facet Thorne, Elizabeth P. C.
Durnea, Constantin M.
Sedgwick, Philip M.
Doumouchtsis, Stergios K.
author_sort Thorne, Elizabeth P. C.
collection PubMed
description OBJECTIVE: To evaluate the impact of a previous pregnancy and delivery on perineal trauma rates in the subsequent vaginal birth. METHODS: Retrospective cohort study. The perineal outcomes of secundiparous women with history of previous (first) delivery in one of three categories: failed operative vaginal delivery (FOVD) and second‐stage emergency cesarean section (EmCS); elective cesarean section (ElCS), and vaginal delivery (VD) with intact perineum, were compared with a control primiparous group. RESULTS: The percentage obstetric anal sphincter injuries (OASIS)at first vaginal delivery was 17.3% (n = 9) after previous FOVD+EmCS, 12.9% (n = 18) after previous ElCS, and 0.6% (n = 9) after previous VD maintaining an intact perineum, compared with 6% (n = 1193) in the control primiparous group of women. Multivariate regression analysis demonstrated that previous FOVD+EmCS and ElCS were associated with a statistically significant increased risk of OASIS of 180% and 110% when compared with control (odds ratio [OR] 2.80; 95% confidence interval [CI] 1.35–5.78 and OR 2.10; 95% CI 1.27–3.48, respectively). Previous VD with intact perineum was associated with a statistically significantly reduced risk of OASIS (OR 0.09; 95% CI 0.04–0.17). CONCLUSIONS: Previous FOVD+EmCS and ElCS were associated with increased risk of OASIS in subsequent vaginal delivery compared with control, whereas previous VD with intact perineum was associated with decreased risk.
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spelling pubmed-97905752022-12-28 Influence of previous delivery mode on perineal trauma risk Thorne, Elizabeth P. C. Durnea, Constantin M. Sedgwick, Philip M. Doumouchtsis, Stergios K. Int J Gynaecol Obstet Clinical Articles OBJECTIVE: To evaluate the impact of a previous pregnancy and delivery on perineal trauma rates in the subsequent vaginal birth. METHODS: Retrospective cohort study. The perineal outcomes of secundiparous women with history of previous (first) delivery in one of three categories: failed operative vaginal delivery (FOVD) and second‐stage emergency cesarean section (EmCS); elective cesarean section (ElCS), and vaginal delivery (VD) with intact perineum, were compared with a control primiparous group. RESULTS: The percentage obstetric anal sphincter injuries (OASIS)at first vaginal delivery was 17.3% (n = 9) after previous FOVD+EmCS, 12.9% (n = 18) after previous ElCS, and 0.6% (n = 9) after previous VD maintaining an intact perineum, compared with 6% (n = 1193) in the control primiparous group of women. Multivariate regression analysis demonstrated that previous FOVD+EmCS and ElCS were associated with a statistically significant increased risk of OASIS of 180% and 110% when compared with control (odds ratio [OR] 2.80; 95% confidence interval [CI] 1.35–5.78 and OR 2.10; 95% CI 1.27–3.48, respectively). Previous VD with intact perineum was associated with a statistically significantly reduced risk of OASIS (OR 0.09; 95% CI 0.04–0.17). CONCLUSIONS: Previous FOVD+EmCS and ElCS were associated with increased risk of OASIS in subsequent vaginal delivery compared with control, whereas previous VD with intact perineum was associated with decreased risk. John Wiley and Sons Inc. 2022-05-22 2022-12 /pmc/articles/PMC9790575/ /pubmed/35426118 http://dx.doi.org/10.1002/ijgo.14218 Text en © 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Articles
Thorne, Elizabeth P. C.
Durnea, Constantin M.
Sedgwick, Philip M.
Doumouchtsis, Stergios K.
Influence of previous delivery mode on perineal trauma risk
title Influence of previous delivery mode on perineal trauma risk
title_full Influence of previous delivery mode on perineal trauma risk
title_fullStr Influence of previous delivery mode on perineal trauma risk
title_full_unstemmed Influence of previous delivery mode on perineal trauma risk
title_short Influence of previous delivery mode on perineal trauma risk
title_sort influence of previous delivery mode on perineal trauma risk
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790575/
https://www.ncbi.nlm.nih.gov/pubmed/35426118
http://dx.doi.org/10.1002/ijgo.14218
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