Abstract:
BACKGROUND:The objectives of this study were to explore the course of labor and the risk of obstetric anal sphincter injury at the first vaginal birth after cesarean section (fVBAC) in comparison to primiparous vaginal birth (PVB) in women without epidural analgesia and to assess if laboring before the previous cesarean affected these outcomes. METHODS:All fVBACs without epidural analgesia and the subsequent PVBs (controls) between 2012 and 2016 were included in this retrospective cohort study. Data were collected from health records and included maternal demographics, gestational age, and labor details (duration of 1st and 2nd stages, labor induction or augmentation, birthweight, operative vaginal birth, estimated blood loss, extent of childbirth trauma) in both groups as well as cervical dilation at the time of previous cesarean in the fVBAC group. Wilcoxon and Chi-square tests were used for data analyses. RESULTS:The study comprised 510 women; 255 fVBACs and 255 controls. The majority of fVBACs were after a pre-labor cesarean section - 177 (69.4%). There was a statistically significant difference in the recorded duration of first stage between the fVBACs and controls (289 vs. 347 min respectively, p < .001). Women were less likely to have an intact perineum in the fVBAC group (29.8 vs. 43.1%, p < 0.01), however, there was no statistically significant difference in anal sphincter injury rates between both groups (2.3 vs. 1.9%, p = 0.76). The groups differed in rates of cervical tears requiring suturing (21.2 vs. 12.9%, p = 0.01). On further subgroup analysis, the duration of first stage of labor was shorter in women who previously had a caesarean section late in labor (≥ 8 cm cervical dilatation) compared to a pre-labor cesarean section, however, there were no differences in other outcomes. CONCLUSION:Compared to primiparous women having a vaginal birth, women having their first vaginal birth after a cesarean section have a shorter 1st stage of labor (particularly if the cesarean was performed in advanced labor), a higher risk of sustaining cervical lacerations and perineal trauma. However, there was no difference in the risk of sustaining obstetric anal sphincter injuries between the study groups.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Rusavy Z,Francova E,Paymova L,Ismail KM,Kalis Vdoi
10.1186/s12884-019-2359-7subject
Has Abstractpub_date
2019-06-20 00:00:00pages
207issue
1issn
1471-2393pii
10.1186/s12884-019-2359-7journal_volume
19pub_type
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-8-8
更新日期:2008-02-28 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/s12884-019-2559-1
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/s12884-018-1882-2
更新日期:2018-06-18 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
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更新日期:2019-01-03 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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doi:10.1186/s12884-020-03112-6
更新日期:2020-07-29 00:00:00
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doi:10.1186/s12884-017-1376-7
更新日期:2017-06-29 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-11-11 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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更新日期:2014-03-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,meta分析
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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更新日期:2009-09-01 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-13-147
更新日期:2013-07-12 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2018-10-20 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1973-0
更新日期:2018-09-20 00:00:00
abstract:BACKGROUND:To evaluate the role of the quality improvement course (QIC) to reduce the caesarean section (CS) rate among nulliparas (Robson groups 1 and 2) and to find out which group of women have reduced the CS rate following attendance at the course. METHODS:The QIC was organized in 2015. For the evaluation of the C...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2020-03-12 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0917-9
更新日期:2016-06-06 00:00:00
abstract:BACKGROUND:This paper analyzes the strategies used by activist health professionals in Argentina who justify providing abortion despite legal restrictions on the procedure. These "insider activists" make a case for abortion rights by linking pregnancy termination to a woman's ability to exert agency at a key point in h...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1498-y
更新日期:2017-11-08 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2400-x
更新日期:2019-07-23 00:00:00