OBJECTIVE: The purpose of this study was to calculate the number of cesarean deliveries needed to prevent 1 case of obstetric anal sphincter laceration associated with operative vaginal delivery in an at-risk cohort. STUDY DESIGN: An institutional, computerized database was used to analyze women with obstructed labor who could have been managed by either operative vaginal or cesarean delivery from September 2006 to March 2008. Women with 1 or more of the following diagnoses comprised the cohort: cephalopelvic disproportion (CPD), arrest of descent, maternal exhaustion, and fetal distress. RESULTS: Fifty (23.9%) out of a total of 209 women managed by operative vaginal delivery experienced an anal sphincter laceration compared to none of 254 women in the cesarean delivery group (P < .0001). The ARR therefore was 23.9% (95% confidence interval, 18.1-29.7) and the NNT was 4.2 (95% confidence interval, 3.4-5.5). CONCLUSION: Five cesarean deliveries are needed to prevent 1 anal sphincter laceration associated with operative vaginal delivery in this cohort.
OBJECTIVE: The purpose of this study was to calculate the number of cesarean deliveries needed to prevent 1 case of obstetric anal sphincter laceration associated with operative vaginal delivery in an at-risk cohort. STUDY DESIGN: An institutional, computerized database was used to analyze women with obstructed labor who could have been managed by either operative vaginal or cesarean delivery from September 2006 to March 2008. Women with 1 or more of the following diagnoses comprised the cohort: cephalopelvic disproportion (CPD), arrest of descent, maternal exhaustion, and fetal distress. RESULTS: Fifty (23.9%) out of a total of 209 women managed by operative vaginal delivery experienced an anal sphincter laceration compared to none of 254 women in the cesarean delivery group (P < .0001). The ARR therefore was 23.9% (95% confidence interval, 18.1-29.7) and the NNT was 4.2 (95% confidence interval, 3.4-5.5). CONCLUSION: Five cesarean deliveries are needed to prevent 1 anal sphincter laceration associated with operative vaginal delivery in this cohort.
Authors: Helain J Landy; S Katherine Laughon; Jennifer L Bailit; Michelle A Kominiarek; Victor Hugo Gonzalez-Quintero; Mildred Ramirez; Shoshana Haberman; Judith Hibbard; Isabelle Wilkins; D Ware Branch; Ronald T Burkman; Kimberly Gregory; Matthew K Hoffman; Lee A Learman; Christos Hatjis; Paul C VanVeldhuisen; Uma M Reddy; James Troendle; Liping Sun; Jun Zhang Journal: Obstet Gynecol Date: 2011-03 Impact factor: 7.661
Authors: Kanoe-Lehua de Silva; Pai-Jong Stacy Tsai; Leanne M Kon; Mark Hiraoka; Bruce Kessel; Todd Seto; Bliss Kaneshiro Journal: Hawaii J Med Public Health Date: 2014-03