{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:37:11Z","timestamp":1761676631496,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,6,26]],"date-time":"2018-06-26T00:00:00Z","timestamp":1529971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There is a paucity of information regarding perineal injuries in women who achieve vaginal birth after caesarean section (<jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To ascertain the rate of severe perineal injuries in women achieving <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> at a major tertiary obstetric hospital, and to determine if vaginal birth is more likely to be associated with perineal injuries in women with one previous caesarean section compared with nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective cohort study was undertaken of women with singleton pregnancies at term who delivered vaginally between 2013 and 2016. We compared nulliparous women with women who had undergone one previous caesarean section. The primary outcome analysed was the rate of third and fourth degree tears in each group. Secondary outcomes were major post\u2010partum haemorrhage and instrumental delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Totals of 10\u00a0663 nulliparous women and 629 <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> women achieved vaginal birth. Of the <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> women, 418 achieved their first vaginal birth (first <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> group). Overall, there was no significant difference in the rate of third and fourth degree tears in the <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> group compared with the nulliparous group (6.0% vs 5.6%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.73). There was no significant increase in anal sphincter injuries in the first <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> group compared with the nulliparous group (6.0% vs 7.4%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.25).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No overall difference in the rate of severe perineal injuries between <jats:styled-content style=\"fixed-case\">VBAC<\/jats:styled-content> women and nulliparous women who achieve vaginal birth was observed in this study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12839","type":"journal-article","created":{"date-parts":[[2018,6,26]],"date-time":"2018-06-26T09:45:07Z","timestamp":1530006307000},"page":"346-350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Perineal trauma with vaginal birth after a previous caesarean section: A retrospective cohort study"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-7361","authenticated-orcid":false,"given":"Jonathan A.S.","family":"Nettle","sequence":"first","affiliation":[{"name":"Department of Obstetrics The Royal Women's Hospital, Melbourne  Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen C.","family":"Mcnamara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Royal Women's Hospital, Melbourne  Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobus M.","family":"Du Plessis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics The Royal Women's Hospital, Melbourne  Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,26]]},"reference":[{"volume-title":"Victorian perinatal services performance indicators 2014\u201315","year":"2016","author":"Department of Health and Human Services","key":"e_1_2_7_2_1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0058577"},{"volume-title":"Birth after previous caesarean section C\u2010Obs 38","year":"2015","author":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists","key":"e_1_2_7_4_1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181eeb251"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02688.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040405"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.04.002"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.025"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0000000000000160"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000232504.32589.3b"},{"volume-title":"Green\u2010top Guideline No.45. 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