RT Generic
T1 Diagnosis of Levator Ani Muscle Avulsion in Instrumented Delivery: Meta-analysis
A1 Antonio Garcia-Mejido, Jose
A1 Fernandez-Palacin, Ana
A1 Lao-Pena, Carolina
A1 Antonio Sainz-Bueno, Jose
K1 assisted birth
K1 birth
K1 forceps
K1 labor
K1 operative
K1 parturition
K1 pelvic floor
K1 perineum
K1 transperineal
K1 ultrasound
K1 vacuum
K1 ventouse
K1 Pelvic floor
K1 Vaginal delivery
K1 Injury
K1 Childbirth
K1 Forceps
K1 Trauma
K1 Women
K1 Impact
K1 Prevalence
K1 Morphology
AB Objective: The objective of this meta-analysis was to establish the rates of levator ani muscle (LAM) avulsion in patients after forceps delivery (FD) and vacuum delivery (VD) as assessed by 3D/4D transperineal ultrasound. Methods: A systematic search was performed in the MEDLINE, PubMed, Google Scholar, and Embase databases up to December 31, 2021. Studies that studied primiparous women diagnosed with LAM avulsion by 3D/4D transperineal ultrasound in VD or FD were included. To do the meta-analysis, the jamovi project program version 2.2 (2021) was used. Results: The search yielded 1225 studies that met the MeSH criteria, of which 26 were included in the review. The estimated joint OR for VD vs. normal vaginal delivery (NVD) was 1.93 (95% CI: 1.31-2.86), for FD vs. NVD was 5.33 (95% CI: 3.78-8.11), and for FD vs. VD was 2.36 (95% CI: 1.46-3.84). Conclusions: Instrumented delivery with forceps or vacuum favors LAM avulsion. It is not possible to establish whether this injury is attributable to the specific instrument or to the type of delivery involved in the instrumentation itself.
PB Imr press
SN 0390-6663
YR 2022
FD 2022-04-01
LK http://hdl.handle.net/10668/21806
UL http://hdl.handle.net/10668/21806
LA en
DS RISalud
RD Apr 9, 2025