Suche
Mein Konto
Vaginal birth after previous cesarean section associated with increased risk of pelvic floor surgery
Having a vaginal birth after a previous cesarean section is associated with an increased risk of pelvic floor surgery compared with planning another cesarean section, according to a study published Nov. 22 in the open-access journal PLOS Medicine. The results provide useful information to help women who have already had a cesarean section plan their next pregnancy. The number of caesarean births has increased significantly worldwide: in the UK, over 30% of all births now take place this way. Guidelines recommend that pregnant women be counseled about the associated risks and benefits of subsequent births after a cesarean section compared to planning a vaginal birth,...
Vaginal birth after previous cesarean section associated with increased risk of pelvic floor surgery
Having a vaginal birth after a previous cesarean section is associated with an increased risk of pelvic floor surgery compared with planning another cesarean section, according to a study published Nov. 22 in the open access journal PLOS Medicine. The results provide useful information to help women who have already had a cesarean section plan their next pregnancy.
The number of caesarean births has increased significantly worldwide: in the UK, over 30% of all births now take place this way. Guidelines recommend that pregnant women be counseled about the associated risks and benefits of subsequent births after a cesarean section compared to planning a vaginal birth so that they can make an informed decision about this choice. However, there is limited evidence on how this choice affects women's risk of pelvic floor disorders, including pelvic organ prolapse, urinary incontinence, rectal prolapse, and fecal incontinence.
Dr. Kathryn Fitzpatrick from Oxford Population Health, University of Oxford, UK, and colleagues conducted a cohort study of 47,414 births to women with one or more previous cesarean sections in Scotland. All births occurred between January 1983 and December 1996, were full-term, and involved only one baby. Nearly 67% planned a vaginal birth after a cesarean section and 33% planned another cesarean section. After an average follow-up of just over 22 years, 1,159 women had pelvic floor surgery, and this was more than twice as likely among women who planned a vaginal birth: Over 1,000 person-years, the rate was 1.75 in the planned vaginal birth birth group and 0.66 among the women who planned another cesarean section. Those planning a vaginal birth were three times more likely to have surgery for pelvic organ prolapse and twice as likely to have urinary incontinence (hazard ratios of 3.17 and 2.26, respectively).
The risks were only increased in women who gave birth vaginally as planned. Those who planned a vaginal birth but had an unplanned cesarean section during labor had a comparable risk to those who planned another cesarean section. The authors hope their research will provide helpful information for women with previous cesarean sections as they make future birth decisions.
Dr. Kathryn Fitzpatrick, who led the study, adds: "Our study shows that among pregnant women who have had a cesarean section in the past, those who have a vaginal birth rather than planning another cesarean section are more likely to have surgery for some type of pelvic floor disorder such as urinary incontinence. Our findings provide important new information to help address the growing number of women in the who have had a cesarean section in the past, to advise on the risks and benefits of their future birth decisions.”
Source:
Reference:
Fitzpatrick, KE, et al. (2022) Planned mode of delivery after prior cesarean section and risk of pelvic floor surgery: A Scottish population-based dataset linkage cohort study. PLOS medicine. doi.org/10.1371/journal.pmed.1004119.
.