Comparison of caesarean section and vaginal delivery for pelvic floor function of parturients: a meta-analysis

To compare the effects and complications of caesarean section (CSD) and vaginal delivery (VD) for pelvic floor function of parturients.

Multiple databases were searched for full-text articles regarding the clinical effects and complications of CSD and VD. Review Manager 5.0 was used for meta-analyses, sensitivity analysis and bias analysis.

In total, 4491 patients were included in nine studies that met the eligibility criteria. Of these, 1527 women underwent CSD and 2944 women had a VD. The meta-analyses suggested significant differences in pelvic floor muscle strength [mean difference (MD) -11.94, 95% confidence interval (CI) -12.48 to -11.39, p < 0.00001, p for heterogeneity <0.00001, I² = 93%], vaginal muscle voltage (MD -9.45, 95% CI -9.73 to -9.16, p < 0.00001, p for heterogeneity <0.00001, I² = 94%), maximum urinary flow rate (MD -5.67, 95% CI -5.94 to -5.39, p < 0.00001, p for heterogeneity <0.00001, I² = 96%), stress urinary incontinence [odds ratio (OR) 0.45, 95% CI 0.37-0.55, p < 0.00001, p for heterogeneity = 0.79, I² = 0%] and pelvic organ prolapse (OR 0.59, 95% CI 0.50-0.70, p < 0.00001, p for heterogeneity = 0.24, I² = 23%) between the CSD group and the VD group.

This study demonstrated that CSD is the preferred mode of delivery for pregnant woman in terms of pelvic floor function.