Earlier observational studies have found that caesarean section (CS), compared with vaginal delivery, is associated with reduced risk of long-term SUI ([OR 0.56 (95%CI 0.47-0.66; n=58,900; 8 studies], (Keag et al,PLoSMed. 2018Jan23;15[1]). Should we therefore be offering elective CS to all women?. Hutton et al (BJOG.2018,in-press) should be congratulated on this large randomised, multicentre trial. The primary analyses were focused on fetal outcomes following either elective CS or planned VD for twins, while this report addresses maternal SUI at 2-year follow-up (FU). At FU, women delivered by elective CS had lower rates of new onset problematic SUI than the planned VD group (8.11% vs 12.25%, OR 0.63, 95%CI 0.47-0.83; p=0.001). This article is protected by copyright. All rights reserved.
BJOG : an international journal of obstetrics and gynaecology. 2018 Aug 01 [Epub ahead of print]
Richard Flint, Linda Cardozo
King's College Hospital, Denmark Hill, London, SE5 9RS.