{"title":"The effects of the intrapartum care model given in line with the recommendations of the World Health Organization (WHO) on the mother’s maternal behavior towards her baby, breastfeeding self-efficacy, breastfeeding success, and hospital discharge readiness: a randomized controlled trial","authors":"Seyhan Çankaya, Esra Tezgören, Hacer Alan Dikmen","doi":"10.1007/s00404-024-07844-0","DOIUrl":"10.1007/s00404-024-07844-0","url":null,"abstract":"<div><h3>Background</h3><p>A woman’s experiences of childbirth, which represents a significant transition in the journey towards motherhood, encompass a range of factors that can influence breastfeeding, parenting behaviors, and readiness for discharge. However, research exploring the intrapartum and postpartum care aspects of the WHO-developed intrapartum care model remains scarce, particularly with regard to breastfeeding, parenting behaviors, and the readiness of the mother in the early postpartum period.</p><h3>Aim</h3><p>The objective of this study was to examine the impact of the intrapartum care model that adheres to the guidelines set forth by the World Health Organization (WHO) on several key outcomes, including the mother’s maternal behavior towards her infant postpartum, breastfeeding self-efficacy, the success of breastfeeding, and the mother’s readiness for hospital discharge.</p><h3>Methods</h3><p>The study was a randomized controlled trial. The study was conducted with 128 primiparous pregnant women (intervention group <i>n</i> = 64, control group <i>n</i> = 64) admitted to the maternity unit of a training and research hospital in a province in the Central Anatolia region of Turkey. The pregnant women in the intervention group were provided with intrapartum care in accordance with the WHO recommendations following the achievement of cervical dilatation reaching 5 cm. The control group was provided with only standard intrapartum and postpartum care. The data were collected using a personal information form, a postpartum parenting behavior scale, a breastfeeding self-efficacy scale, a breastfeeding charting system and documentation tool (LATCH), and a hospital discharge readiness scale.</p><h3>Results</h3><p>The mean scores for parenting behavior and breastfeeding self-efficacy of the women in the intervention group who received intrapartum care in accordance with the World Health Organization (WHO) recommendations were found to be significantly higher than those of the women in the control group (<i>p</i> < 0.001). Additionally, the mean LATCH score of the women in the intervention group (9.6 ± 0.8) was higher than that of the women in the control group (8.4 ± 1.6) and no breastfeeding problems were observed (<i>p</i> < 0.001). The women in the intervention group exhibited a higher level of readiness for hospital discharge (176.3 ± 10.7) compared to the women in the control group (149.6 ± 13.7). The mean score for the subscale “expected support” on the readiness for hospital discharge scale was found to be 9 ± 7.2 in the intervention group, which was considerably lower than the mean score of the control group (15.2 ± 8.4). It was determined that women in the intervention group who received the intrapartum care model required less support in the postpartum period compared to women in the control group (<i>p</i> < 0.001).</p><h3>Conclusion</h3><p>The intrapartum care model provided in line with WHO recommendations increases m","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"3009 - 3027"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonas Bubmann, Carl Mathis Wild, Christian Dannecker, Manuela Franitza, Bernadette Eser, Marina C Seefried, Thomas Kroencke, Philipp Voisard, Udo Jeschke, Fabian Garrido
{"title":"Review on Symptomatic pedunculated leiomyomas in pregnancy with special consideration of an example case.","authors":"Jonas Bubmann, Carl Mathis Wild, Christian Dannecker, Manuela Franitza, Bernadette Eser, Marina C Seefried, Thomas Kroencke, Philipp Voisard, Udo Jeschke, Fabian Garrido","doi":"10.1007/s00404-024-07840-4","DOIUrl":"https://doi.org/10.1007/s00404-024-07840-4","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Symptomatic pedunculated leiomyomas in pregnancy; review of the literature with special consideration of an example case.</p><p><strong>Study design: </strong>Retrospective narrative review with an example case.</p><p><strong>Methods: </strong>Systematic evaluation of 37 reports.</p><p><strong>Example case: </strong>A 36-year-old Caucasian primigravida was referred symptomatic at 16 + 0 weeks due to a 13,5 cm myoma causing pain, constipation, urine retention and dysesthesias. Our patient underwent myomectomy at 17 + 0 weeks. One pedunculated leiomyoma was successfully removed.</p><p><strong>Conclusion: </strong>Myomectomy can be performed and is safe for pedunculated fibroids in pregnancy. Depending on the clinical scenario, surgical removal may be indicated. Based on the size of the fibroids and expected adhesions, a laparotomy is a safe option and is not a contraindication for vaginal birth in the case of pedunculated fibroids. Myomas larger than 10 cm should be removed by laparotomy.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omima T Taha, Hanan M Ghoneim, Tyseer Marzouk, Tamer Yehia M Ali
{"title":"Association between placental site and successful induction of labor among postdate primiparous women.","authors":"Omima T Taha, Hanan M Ghoneim, Tyseer Marzouk, Tamer Yehia M Ali","doi":"10.1007/s00404-024-07765-y","DOIUrl":"https://doi.org/10.1007/s00404-024-07765-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the association between placental site and successful labor induction.</p><p><strong>Methods: </strong>This cross-sectional study recruited all postdate primiparous women undergoing induction of labor. Eligible women were subjected to proper history taking and clinical examination. Vaginal examination to determine the bishop score was done. Routine antenatal scan was done for fetal biometry and the placental site. Transvaginal ultrasound was done for cervical length assessment. Induction of labor was commenced and women were subdivided into those with successful induction (delivered vaginally) and those with failed induction (needed cesarean delivery).</p><p><strong>Results: </strong>Successful induction was achieved in 73/91 (80.2%) participants. The bishop score was significantly increased among women with successful induction (4.6 ± 0.9 vs 3.9 ± 1.1, p value 0.014). In addition, the cervical length was significantly shorter among those who delivered vaginally (2.6 ± 0.5 vs 4.2 ± 0.5, p value 0.0001). There was no significant difference in the placental site among women with failed or successful induction. The cervical length was the only significant predictor for successful induction of labor (p value 0.0001). The placental site showed a non-significant role in the prediction of successful vaginal delivery (p value 0.280).</p><p><strong>Conclusion: </strong>The placental site is not associated with the outcome of labor induction. The cervical length was the significant predictor for successful induction of labor.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Sayed, Anwar A Sayed, Delnaz Fard, Peter Hillemanns, Constantin Von Kaisenberg, Rüdiger Klapdor
{"title":"Effect of mother's active pushing at cesarean delivery: a randomized controlled trial.","authors":"Ahmed Sayed, Anwar A Sayed, Delnaz Fard, Peter Hillemanns, Constantin Von Kaisenberg, Rüdiger Klapdor","doi":"10.1007/s00404-024-07835-1","DOIUrl":"https://doi.org/10.1007/s00404-024-07835-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effect of maternal active pushing during cesarean section (CS) on postoperative pain, intraoperative discomfort, and the mother's sense of control and participation.</p><p><strong>Design: </strong>A prospective, randomized controlled study.</p><p><strong>Methods: </strong>Patients were randomly assigned into two groups. In the Conventional group (n = 45), the CS was performed traditionally without maternal pushing. In the Assisted group (n = 55), patients were instructed to push during delivery. Outcomes measures included patients' perceived pressure, pain, and sense of participation. Breastfeeding and postnatal depression were assessed using validated scales, along with maternal and neonatal outcomes, surgeon satisfaction, and operation duration.</p><p><strong>Results: </strong>Patients in the Assisted group reported significantly lower fundal pressure intensity (VAS score 3 vs. 5, P < 0.01) compared to the Conventional group. There was no significant difference in postoperative pain. However, women in the Assisted group reported a greater sense of participation (6 vs. 0, P < 0.01) and control (4 vs. 0, P < 0.05) than those in the Conventional group. No significant maternal or neonatal complications were observed.</p><p><strong>Conclusion: </strong>Maternal active pushing during CS positively impacted intraoperative experience by reducing perceived pressure and enhancing the sense of control and participation, without adverse effects on maternal or neonatal outcomes. These findings support further research with larger, multi-center studies to validate the potential benefits of this approach.</p><p><strong>Trial registration: </strong>NCT05520580 ( https://clinicaltrials.gov/ct2/show/NCT05520580 ).</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unveiling the neonatal gut microbiota: exploring the influence of delivery mode on early microbial colonization and intervention strategies","authors":"Guangyu Ma, Zhongsheng Chen, Zhe Li, Xiaomin Xiao","doi":"10.1007/s00404-024-07843-1","DOIUrl":"10.1007/s00404-024-07843-1","url":null,"abstract":"<div><p>Recent research has emphasized the critical importance of establishing the neonatal gut microbiota for overall health and immune system development, prompting deeper studies about the early formation of neonatal gut microbiota and its influencing factors. Various factors, including maternal and environmental factors, affect the early formation of neonatal gut microbiota, in which delivery mode has been considered as one of the most crucial influencing factors. In recent years, the increasing trend of cesarean section during childbirth has become a serious challenge for global public health. This review thoroughly analyzes the effects of vaginal delivery and cesarean section on the establishment of neonatal gut microbiota and the potential long-term impacts. In addition, we analyze and discuss interventions such as probiotics, prebiotics, vaginal seeding, fecal microbiota transplantation, and breastfeeding to address the colonization defects of the neonatal gut microbiota caused by cesarean section, aiming to provide theoretical basis for the prevention and treatment of colonization defects and related diseases in infants caused by cesarean section in clinical practice and to provide a theoretical foundation for optimizing the development of neonatal gut microbiota.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"2853 - 2861"},"PeriodicalIF":2.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of using a birth ball on birth satisfaction and pain in pregnant women during labor: a randomized controlled trial","authors":"Yasemin Erkal Aksoy, Sema Dereli Yilmaz, Şerife Çelimli","doi":"10.1007/s00404-024-07825-3","DOIUrl":"10.1007/s00404-024-07825-3","url":null,"abstract":"<div><h3>Purpose</h3><p>This study was applied to evaluate the effect of birth ball use on birth satisfaction and pain levels of pregnant women during labor.</p><h3>Methods</h3><p>The type of study is randomized controlled. The data of the study were collected in the delivery room of a state hospital in Konya/Türkiye between March 2020 and December 2021. The sample of the study consisted of 57 pregnant women for the intervention group and 54 pregnant women for the control group. During labor, intervention group was seated on the birth ball in an upright position; control group was laid on the bed in semi-fawler or lateral positions. In the study, Descriptive Information Form, Birth Process Follow-up Form, Visual Analog Scale and Birth Satisfaction Scale-Revised were used as data collection tools.</p><h3>Results</h3><p>It was determined that the pain scores of the pregnant women in the intervention group were lower during the first and second follow-up than the control group. The duration of the active phase of labor in the intervention group was shorter than in the control group, and a statistically significant difference was found between them. It was found that the Birth Satisfaction Scale-Revised total score, the sub-dimensions of quality of care, women’s attributes and stress experienced during labor of the pregnant women in the intervention group were higher than the control group.</p><h3>Conclusion</h3><p>According to the results of the study, the use of a birth ball during the active phase of labor reduces the pain level during labor and increases the level of birth satisfaction of pregnant women.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"2999 - 3007"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clementina Viscardi, Mauro Francesco Pio Maiorano, Ondina Popescu, Gennaro Cormio, Vera Loizzi
{"title":"Female adnexa tumour of probable wolffian origin (FATWO)","authors":"Clementina Viscardi, Mauro Francesco Pio Maiorano, Ondina Popescu, Gennaro Cormio, Vera Loizzi","doi":"10.1007/s00404-024-07831-5","DOIUrl":"10.1007/s00404-024-07831-5","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"3257 - 3258"},"PeriodicalIF":2.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tao Liu, Kuo Miao, Gaoqiang Tan, Hanqi Bu, Mingda Xu, Qiming Zhang, Qin Liu, Xiaoqiu Dong
{"title":"Exploratory study on the enhancement of O-RADS application effectiveness for novice ultrasonographers via deep learning","authors":"Tao Liu, Kuo Miao, Gaoqiang Tan, Hanqi Bu, Mingda Xu, Qiming Zhang, Qin Liu, Xiaoqiu Dong","doi":"10.1007/s00404-024-07837-z","DOIUrl":"10.1007/s00404-024-07837-z","url":null,"abstract":"<div><h3>Purpose</h3><p>The study aimed to create a deep convolutional neural network (DCNN) model based on ConvNeXt-Tiny to identify classic benign lesions (CBL) from other lesions (OL) within the Ovarian-Adnexal Reporting and Data System (O-RADS), enhancing the system's utility for novice ultrasonographers.</p><h3>Methods</h3><p>Two sets of sonographic images of pathologically confirmed adnexal lesions were retrospectively collected [development dataset (DD) and independent test dataset (ITD)]. The ConvNeXt-Tiny model, optimized through transfer learning, was trained on the DD using the original images directly and after automatic lesion segmentation by a U-Net model. Models derived from both training paradigms were validated on the ITD for sensitivity, specificity, accuracy, and area under the curve (AUC). Two novice ultrasonographers were assessed in O-RADS with and without assistance from the model for Application Effectiveness.</p><h3>Results</h3><p>The ConvNeXt-Tiny model trained on original images scored AUCs of 0.978 for DD and 0.955 for ITD, while the U-Net segmented image model achieved 0.967 for DD and 0.923 for ITD; neither showed significant differences. When assessing the malignancy of lesions using O-RADS 4 and 5, the diagnostic performances of two novice ultrasonographers and senior ultrasonographer, as well as model-assisted classifications, showed no significant differences, except for one novice's low accuracy. This approach reduced classification time by 62 and 64 min. The kappa values with senior doctors' classifications rose from 0.776 and 0.761 to 0.914 and 0.903, respectively.</p><h3>Conclusion</h3><p>The ConvNeXt-Tiny model demonstrated excellent and stable performance in distinguishing CBL from OL within O-RADS. The diagnostic performance of novice ultrasonographers using O-RADS is essentially equivalent to that of senior ultrasonographer, and the assistance of the model can enhance their classification efficiency and consistency with the results of senior ultrasonographer.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"3111 - 3120"},"PeriodicalIF":2.1,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saskia-Laureen Herbert, A S Payerl, M Prange, S Löb, J Büchel, A Scherer-Quenzer, M Kiesel, A Wöckel, H Faller, K Meng
{"title":"Supportive care and information needs in relation to quality of life among patients with breast cancer and gynaecological cancer during the time of treatment.","authors":"Saskia-Laureen Herbert, A S Payerl, M Prange, S Löb, J Büchel, A Scherer-Quenzer, M Kiesel, A Wöckel, H Faller, K Meng","doi":"10.1007/s00404-024-07805-7","DOIUrl":"https://doi.org/10.1007/s00404-024-07805-7","url":null,"abstract":"<p><strong>Purpose: </strong>Although therapy and psychosocial care for patients with breast cancer and gynaecological cancer has improved in the last years, there are still many issues that require further investigation. Unmet supportive care needs can lead to a lower adherence to treatment and a lower quality of life. Patients' needs seem to be highest during the time of treatment. Thus, this study investigated needs and quality of life.</p><p><strong>Methods: </strong>In this German prospective study, we enrolled 292 patients with breast cancer and gynaecological cancer during the time of treatment. Data on needs were assessed using instruments that had proven feasible in earlier studies. Data on quality of life (QoL) were assessed using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30). We investigated correlations between needs and sociodemographic data as well as quality of life.</p><p><strong>Results: </strong>Among all cancer entities we observed that 150 patients (51.5%) showed unmet information needs, 221 patients (75.7%) showed at least one high supportive care need, and 91 patients (31.2%) had psychological care needs. Data showed statistically significant correlations between these needs and sociodemographic data as well as quality of life. These correlations generally showed small to medium effect sizes. Older women showed less supportive care needs (r = - 0.24; p < 0.001), (r = - 0.15; p = 0.010). Furthermore, recruitment after surgery was associated with statistically significant higher information needs (r = 0.14; p = 0.015), whereas recruitment during chemotherapy was associated with statistically significant less information needs (r = - 0.15; p = 0.013). Positive correlations were shown for the level of received information and physical functioning (r = 0.12; p = 0.047), social functioning (r = 0.16; p = 0.009) and global quality of life (r = 0.19, p = 0.002) as well as satisfaction with information and physical (r = 0.16; p = 0.006), social (r = 0.24; p < 0.001), cognitive functioning (r = 0.14; p = 0.017) as well as global quality of life (r = 0.25; p < 0.001). Negative correlations were reported for information needs and emotional functioning (r = - 0.12; p = 0.035) and global quality of life (r = - 0.15; p = 0.011). Supportive care needs also correlated negatively with physical (r = - 0.23; p < 0.001), role (r = - 0.23; p < 0.001), emotional (r = - 0.35; p < 0.001), cognitive (r = - 0.24; p < 0.001), social functioning (r = - 0.30; p < 0.001), and global quality of life (r = - 0.35; p < 0.001). Also, patients with at least one high supportive care need correlated negatively with role (r = - 0.15; p = 0.014), emotional (r = - 0.23; p < 0.001), social functioning (r = - 0.30; p = 0.001), and global quality of life (r = - 0.35; p < 0.001). There was no statistical significance concerning cancer side. Thus, both groups are reported together. Furthermore, there was no statisti","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Doroldi, Linda Piemonti, Marina Valeriani, Laura Larcher, Jacopo Lenzi, Elena Contro
{"title":"Risk factors for bladder injuries during cesarean sections: insights from a 15 year experience at a tertiary care center and a systematic review with meta-analysis","authors":"Sara Doroldi, Linda Piemonti, Marina Valeriani, Laura Larcher, Jacopo Lenzi, Elena Contro","doi":"10.1007/s00404-024-07826-2","DOIUrl":"10.1007/s00404-024-07826-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify potential risk factors for bladder injury during cesarean section (CS).</p><h3>Methods</h3><p>We conducted an observational case–control study from 2009 to 2024 at our Tertiary Care Hospital, matching each bladder injury case with four controls. Additionally, a systematic review and meta-analysis of the literature was performed using MEDLINE, CINAHL, and Scopus, from inception to 2024; eligible studies were case–control studies assessing risk factors for bladder injury during CS. Random-effects regression with the restricted maximum likelihood method was employed for the meta-analysis.</p><h3>Results</h3><p>We identified 23 cases of bladder injury out of 15,260 CSs at our hospital, resulting in a rate of 0.15%. Women with bladder injuries were significantly older (<i>p</i> = 0.022), with 47.8% having a history of previous CS, while no significant differences were observed between groups regarding prior abdominal surgery, endometriosis, or body mass index. The systematic review included four case–control studies, whose data were meta-analyzed with our patients, identifying several significant predictors: adhesions (OR 18.6, 95% CI 8.86–39.0), repeated CS (OR 3.25, 95% CI 2.02–5.23), emergent procedures (OR 3.15, 95% CI 1.71–5.80), failed vaginal birth after cesarean (OR 4.74, 95% CI 2.18–10.3), second stage of labor (OR 2.78, 95% CI 1.80–4.29), and macrosomia (OR 2.64, 95% CI 1.25–5.57).</p><h3>Conclusions</h3><p>Key risk factors for cesarean bladder injury include prior CSs, adhesions, second stage of labor, macrosomia, failed VBAC, and emergent procedures. Identifying these risk factors is critical for preoperative assessment and counseling, allowing for better surgical planning and improved outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"2829 - 2838"},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}