Int J Gynaecol Obstet. 2022 Apr 15. doi: 10.1002/ijgo.14218. Online ahead of print.
ABSTRACT
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 caesarean section (EmCS); elective caesarean section (ELCS), and vaginal delivery (VD) with intact perineum, were compared with a control primiparous group.
RESULTS: The percentage OASIs at first vaginal delivery after prior FOVD+EmCS was 17.3%(n=9), 12.9%(n=18) after previous ELCS, and 0.6%(n=9) after prior VD maintaining an intact perineum, compared with 6%(n=1193) in the control primiparous group of women. Multivariate regression analysis demonstrated prior FOVD+EmCS and ELCS were associated with a statistically significant increased risk of OASIs of 180% and 110% when compared to 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. Prior 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 to control, whilst previous VD with intact perineum was associated with decreased risk.
PMID:35426118 | DOI:10.1002/ijgo.14218
