General Gynecology and Pelvic Floor
Leila Pourali; maryam salehi; reyhaneh rahmani; elmira fardi; sedigheh ayati; hasan Mehrad-Majd; mehrdad gazanchian; elham rahmanipour; mohammad ghorbani; Ali mehri
Articles in Press, Accepted Manuscript, Available Online from 16 July 2023
Abstract
Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS). Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).Search strategy: Systematic review and meta-analysisSelection criteria and Data collection: ...
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Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS). Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).Search strategy: Systematic review and meta-analysisSelection criteria and Data collection: We searched MEDLINE, EMBASE, PubMed, Scopus, using search terms (cesarean OR cesarean OR caesarean OR caesarian) AND (“Vaginal birth after” OR VBAC) AND (two OR Twice OR second OR multiple Two independent reviewers performed the study selection, and abstracted and tabulated data and pooled estimates were obtained. Meta-analyses were performed using Open-meta and Comprehensive Meta-Analysis.Main results: Mean success rate of VBAC-2 was 72% (2174 out of 3020 cases) with a range of 24-90%. Mean hysterectomy rate was 0.43% ranging from 0% to 1.7%. Our meta-analysis showed no significant difference between VBAC-2 and CS-3 in the case of hysterectomy, with a pooled odds ratio (OR) of 0.699, but with a wide confidence interval (95% CI was 0.347-1.407). VBAC-2 being associated with 2 fold increased risk of perinatal mortality compared to CS-3. Conclusion: Vaginal delivery is a suitable option for women with two previous cesarean sections, the outcomes are significantly more favorable for women with history of vaginal birth.
Obstetrics and Gynecology
Neda Hashemi; Zahra Soleimani
Volume 7, Issue 6 , September and October 2022, , Pages 513-517
Abstract
Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis ...
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Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis infection and risk of female infertility.Materials & Methods: Web of Science, PubMed and Scopus were searched using appropriate keywords as major international electronic bibliographic databases up to January 2020. Q-test and I2 statistic were used for evaluating heterogeneity between studies as well as Begg's and Egger's tests for exploring publication. Results were reported by pooled odds ratio (OR) estimate from individual studies by choosing random-effects model.Results: In total, 650 articles were obtained by initial search until January 2020 with 9779 women. Results of the pooled OR estimates showed a significant association between T. vaginalis and infertility in adjusted studies (OR=1.95; 95% CI: 1.46, 2.43). Based on Begg's and Egger's tests, there was no evidence of publication bias (P < /i>=0.532 and P < /i>=0.896, respectively).Conclusion: There was a significant association between T. vaginalis and female infertility. However, more evidence is necessary to prove the potential association of T. vaginalis with an increased risk of female infertility.