Advertisement

Obstetric Anal Sphincter Injury [OASI]

  • Swati Jha
  • Abdul Sultan
Chapter

Abstract

Obstetric Anal Sphincter Injury has seen an increasing incidence in the past few years which may be related to improved detection and diagnosis. The risk factors for OASI are not modifiable and therefore strategies aimed at reducing incidence during childbirth as well as adequate diagnosis of the grade of tear and its appropriate management reduces adverse sequela. These are not guaranteed to avoid faecal incontinence in later life but the commonest cause of litigation relates to failure to detect tears at the time of delivery.

Keywords

OASI Obstetric anal sphincter injury Faecal incontinence Severe perineal trauma Buttonhole tears 

References

  1. 1.
    Thiagamoorthy G, Johnson A, Thakar R, Sultan AH. National survey of perineal trauma and its subsequent management in the United Kingdom. Int Urogynecol J. 2014;25(12):1621–7.  https://doi.org/10.1007/s00192-014-2406-x.CrossRefPubMedGoogle Scholar
  2. 2.
    Andrews V, Thakar R, Sultan AH, Jones PW. Occult anal sphincter injuries – myth or reality? BJOG. 2006;113:195–200.CrossRefPubMedGoogle Scholar
  3. 3.
    Sultan AH, Thakar R, Fenner D. Perineal and anal sphincter trauma. London: Springer; 2007.CrossRefGoogle Scholar
  4. 4.
    RCOG. The management of third and fourth degree perineal tears. Green Top Guideline No 29; 2015.Google Scholar
  5. 5.
    Nordenstam J, Mellgren A, Altman D, Lopez A, Johansson C, Anzen B, et al. Immediate or delayed repair of obstetric anal sphincter tears-a randomised controlled trial. BJOG. 2008;115(7):857–65.CrossRefPubMedGoogle Scholar
  6. 6.
  7. 7.
    Intrapartum Care for healthy women and their babies. NICE (National Institute for Health and Clinical Excellence). CG190; 2014. www.org.uk/guidance/cg190.
  8. 8.
    Fernando RJ, Sultan AH, Kettle C, Thakar R. Methods of repair for obstetric anal sphincter injury. Cochrane Database Syst Rev. 2013;12:CD002866.  https://doi.org/10.1002/14651858.CD002866.pub3.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyJessop Wing, Sheffield Teaching Hospitals NHS TrustSheffieldUK
  2. 2.Croydon University HospitalLondonUK

Personalised recommendations