Question: 25 yr old primigravida 38 weeks past history of successful treatment of anal atresia ? LSCS?
Please note: the search for this response was carried out over 1 year ago. Eligible users may request an update of the evidence by submitting a new Clinical Query here.
Answer: Four case reports of pregnancies in women after surgical repair of anal atresia, have been reported. (1-4) All were delivered by caesarean section.
A case note review was undertaken of 20 women who had 29 live babies after lower urinary tract reconstruction for congenital abnormalities (including one case of anal atresia).(5) 10 of the births were normal or assisted vaginal deliveries, seven patients had emergency caesarean sections, and 12 had elective Caesarean sections for obstetric indications.
(Evidence level III)
References:
- Salvi N. Arthur I. A case of successful pregnancy outcome in a patient born with cloacal malformation. Journal of Obstetrics and Gynaecology. 28(3)(pp 343-345), 2008.
- Joo J.G. Gavai M. Urbancsek J. Murber A. Papp Z. A case of a full term pregnancy following IVF-ET in a patient having undergone operations for anus atresia and rectovaginal fistula in the newborn period and for subseptum of the uterus in adulthood. Magyar Noorvosok Lapja. 67(2)(pp 81-83), 2004.
- Resnik E. Laifer SA. O'Donnell WF. Transvesical cesarean following bowel and urinary tract reconstructive surgery. Obstetrics & Gynecology. 79(5 ( Pt 2)):884-6, 1992 May. Abstract Full text available to Fellows, Members and Trainees
- Mariona G. Evans T.N. Pregnancy following repair of anal and vaginal atresia and bladder exstrophy. Obstetrics and Gynecology. 59(5)(pp 653-655), 1982. Abstract Full text available to Fellows, Members and Trainees
- Greenwell T.J. Venn S.N. Creighton S. Leaver R.B. Woodhouse C.R.J. Pregnancy after lower urinary tract reconstruction for congenital abnormalities. BJU International. 92(7)(pp 773-777), 2003. Full text
Search date: March 2009
Classification of evidence levels
Ia Evidence obtained from meta-analysis of randomised controlled trials.
Ib Evidence obtained from at least one randomised controlled trial.
IIa Evidence obtained from at least one well-designed controlled study without randomisation.
IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.
III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.
IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
This clinical query answer was produced following the clinical query protocol as described here.
The RCOG will not be liable for any special or consequential damages arising from the use or reliance on information contained within the Query Bank.
