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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
Currently 3053 records
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Created on : 18 Dec 2003
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Elective cesarean delivery for women with a previous anal sphincter rupture. American Journal of Obstetrics and Gynecology. 2003;189(5):1251-56.

Author(s) :

McKenna DS, Ester JB, Fischer JR.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

The purpose of this study was to evaluate elective cesarean delivery for women with a history of anal sphincter rupture.

The effectiveness of cesarean delivery in parous women with a previous anal sphincter rupture was determined by decision analysis. The outcomes were excess cesarean deliveries and morbidity and mortality rates per prevented case of anal incontinence.

We needed 2.3 cesarean deliveries to prevent one case of anal incontinence. A woman who chooses a cesarean delivery has a 11.3% risk of morbidity compared with a 4.2% risk for vaginal delivery (relative risk, 2.7; 95% CI, 2.6-2.8; P<.001). The relative risk for maternal death from a cesarean delivery is 2.6 (95% CI, 1.5-4.5; P<.001).

Continent women with a previous anal sphincter rupture who are delivered vaginally are at high risk for permanent anal incontinence. Cesarean delivery will prevent most cases of anal incontinence, although marginally increasing maternal risk. The increased risk may be justified by the potential benefits. Patients should be counseled on these risks and benefits.

Sumário (português)  :

Comments :

Argument (français) :

Argument (English):

Argumento (português):

Keywords :

➡ c-section/caesarean ; evidence-based medicine/midwifery ; perineal/vaginal tears ; morbidity

Author of this record :

Cécile Loup — 18 Dec 2003

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