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Seeking the Truth About Primary Elective Cesarean Delivery and Pelvic Floor Disorders: A Systematic Review and Meta-Analysis.
Tholemeier, Lauren; Souders, Colby P; Bresee, Catherine; Nik-Ahd, Farnoosh; Caron, Ashley; Eilber, Karyn S; Anger, Jennifer T.
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  • Tholemeier L; From the Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA.
  • Souders CP; Department of Urology, UT Southwestern Medical Center, Dallas, TX.
  • Bresee C; Biostatistics Core at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles.
  • Nik-Ahd F; Department of Urology, UC San Francisco Medical Center, San Francisco, CA.
  • Caron A; Michigan State University College of Human Medicine, Grand Rapids, MI.
  • Anger JT; Department of Urology, UC San Diego Medical Center, La Jolla, CA.
Female Pelvic Med Reconstr Surg ; 28(3): e108-e114, 2022 03 01.
Article en En | MEDLINE | ID: mdl-35272343
IMPORTANCE: A better understanding of the effect of elective cesarean delivery (CD) on the development of pelvic floor disorders can help obstetricians counsel pregnant women. OBJECTIVE: This study aimed to perform a systematic review and meta-analysis evaluating whether primary elective CD is protective against pelvic floor disorders. STUDY DESIGN: Using the MOOSE criteria, electronic databases were searched for studies that compared the prevalence of pelvic floor disorders among primiparous women. Outcomes of interest were urinary incontinence (UI), fecal incontinence (FI), anal incontinence (AI), and pelvic organ prolapse (POP). Comparisons were made between CD before the onset of labor ("Elective CD"), CD after trial of labor ("Labor CD"), and vaginal delivery (VD). Risk ratios (RRs) were computed using STATA. Between-study heterogeneity was assessed via Cochrane's homogeneity test and review of the I2 statistic. RESULTS: Nineteen studies were included. The overall prevalence of UI for Elective CD was estimated at 7% (95% confidence interval [CI], 3%-13%), Labor CD at 14% (95% CI, 8%-21%), and VD at 26% (95% CI, 20%-32%). Meta-analysis demonstrated a decreased risk of UI after Elective CD compared with Labor CD (RR, 0.75; P = 0.011) or VD (RR, 0.43; P < 0.001). There was a decreased risk of FI or AI after Elective CD compared with VD, but not when compared with Labor CD. Only 2 studies examined POP, precluding meta-analysis. CONCLUSIONS: Among primiparous women, Elective CD may be protective against UI when compared with Labor CD. There was not a protective effect of Elective CD against FI and AI when compared with Labor CD. More data on the effect of elective CD on POP are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Urinaria / Incontinencia Fecal / Trastornos del Suelo Pélvico Tipo de estudio: Etiology_studies / Risk_factors_studies / Systematic_reviews Límite: Female / Humans / Male / Pregnancy Idioma: En Revista: Female Pelvic Med Reconstr Surg Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Incontinencia Urinaria / Incontinencia Fecal / Trastornos del Suelo Pélvico Tipo de estudio: Etiology_studies / Risk_factors_studies / Systematic_reviews Límite: Female / Humans / Male / Pregnancy Idioma: En Revista: Female Pelvic Med Reconstr Surg Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos