Introduction
Methods
Search strategy
Patients | Outcome | |
---|---|---|
Caesarean | Uterine | Separation |
Caesarean | Uterus | Rupture |
Section | Scar | Dehiscence |
Scar | ||
VBAC | ||
Search syntax | ||
(caesarean[TIAB] OR caesarean[TIAB] OR section[TIAB] OR scar[TIAB] OR VBAC[TIAB]) AND (uterine[TIAB] OR uterus[TIAB] OR scar[TIAB]) AND (seperation[TIAB] OR rupture[TIAB] OR dehiscence[TIAB]) |
Critical appraisal
Study | Relevance | Validity | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Patientsa
| Predictorb
| Outcomec
| Overall relevance | Study designd
| Control groupe
| Blinding for PVD statusf
| Selection biasg
| Population sizeh
| Subset analysisi
| Prediction rulesj
| Outcome measuresk
| Level of evidencel
| Overall validity | |
Bedoya et al. [22] | + | +/− | +/− | 2 | +/− | + | – | +/− | – | +/− | +/− | – | 2− | 3 |
Shimonovitz et al. [30] | + | – | +/− | 1.5 | – | + | – | +/− | +/− | + | +/− | – | 2− | 3.5 |
Zelop et al. [29] | + | +/− | + | 2.5 | +/− | + | – | + | +/− | + | +/− | +/− | 2+ | 5 |
Hendler and Bujold [25] | + | + | +/− | 2.5 | +/− | + | – | + | +/− | + | +/− | +/− | 2+ | 5 |
Smith et al. [28] | + | +/− | +/− | 2 | +/− | + | – | +/− | + | +/− | +/− | +/− | 2+ | 4.5 |
Macones et al. [26] | +/− | +/− | +/− | 1.5 | – | + | – | +/− | + | +/− | +/− | + | 2+ | 4.5 |
Grobman et al. [23] | + | +/− | +/− | 2 | + | + | – | + | + | + | +/− | + | 2+ | 6.5 |
Kwee et al. [5] | +/− | +/− | + | 2 | + | + | – | +/− | +/− | + | +/− | +/− | 2++ | 5 |
Grobman et al. [24] | + | +/− | +/− | 2 | + | + | – | + | + | +/− | + | + | 2+ | 6.5 |
Mercer et al. [27] | +/− | – | +/− | 1 | + | + | – | + | + | + | +/− | + | 2++ | 6.5 |
Statistical analysis
Results
Search
Critical appraisal
Prior vaginal delivery and uterine rupture
Study | Study design | Population size | AR without vaginal delivery (%) | AR with vaginal delivery (%) | Odds ratio | 95% Confidence interval |
---|---|---|---|---|---|---|
Hendler and Bujold [25] | Retrospective cohort | 2,204 |
1.54
|
0.39
|
OR 0.24*
|
0.06–1.03
|
Smith et al. [28] | Retrospective cohort | 35,854 |
0.43
|
0.17
|
OR 0.39
|
0.25–0.62
|
Zelop et al. [29] | Retrospective cohort | 3,783 | 1.1 | 0.20 | OR 0.18 | 0.04–0.74 |
Kwee et al. [5] | Prospective cohort | 3,273 |
1.7
|
0.82
|
OR 0.47
|
0.21–1.05
|
Grobman et al. [23] | Prospective cohort | 11,778 |
1.0
|
0.46
|
OR 0.45
|
0.28–0.70
|
Grobman et al. [24]a
| Prospective cohort | 11,816 | 0.95 | 0.43 | OR 0.44 | 0.27–0.71 |