Delivery mode and the risk of levator muscle avulsion: a meta-analysis

Introduction and hypothesis Female pelvic organ prolapse (POP) is a common condition, with a lifetime risk for surgery of 10–20%. Pregnancy and childbirth are the commonest modifiable risk factors for POP, and avulsion of the levator ani muscle is likely to be an etiological factor. Avulsion is more common in instrumental delivery. However, we were unable to identify a meta-analysis on this issue. Our aim was to perform a systemic review and quantitative meta-analysis of the prevalence of avulsion relative to delivery mode.