Mode of Delivery After Previous Obstetric Anal Sphincter Injuries (OASIS)--a Reappraisal?

Overview

Journal Int Urogynecol J Pelvic Floor Dysfunct

Specialties Gynecology & Obstetrics
Urology

Date 2009 May 29

PMID 19475329

Citations 24

Authors

Inka Scheer

Ranee Thakar

Abdul H Sultan

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: To prospectively evaluate anorectal symptoms, quality of life (QoL), sphincter integrity and function after subsequent childbirth following previous obstetric anal sphincter injuries (OASIS).

Methods: A validated Manchester Health Questionnaire, endoanal sonography and manometry were performed during the third trimester and 13 weeks postpartum. Women without objective compromise of anal function were recommended a vaginal delivery and the others a caesarean section.

Results: Seventy-three consecutive women with previous OASIS were seen during a subsequent pregnancy of whom 59 were reviewed 13 weeks following delivery. Anal manometry findings did not change significantly following a subsequent vaginal delivery or caesarean section. Only one new defect (internal sphincter) occurred after a vaginal delivery. There was no significant change in symptoms or QoL. Three (6.8%) sustained repeat OASIS.

Conclusions: Women who have no antenatal evidence of objective compromise of anal sphincter function can be reassured that a vaginal delivery is not associated with any significant deterioration in function or QoL.

Citing Articles

Obstetric Perineal Tears, Birth Characteristics and the Association with Urinary Incontinence Among Primiparous Women 12 Months Postpartum: A Prospective Cohort Study.

Gommesen D, Hjorth S, Nohr E, Qvist N, Rasch V Int Urogynecol J. 2024; 35(10):2033-2044.

PMID: 39284971 PMC: 11534832. DOI: 10.1007/s00192-024-05920-2.

Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020).

Kropshofer S, Aigmuller T, Beilecke K, Frudinger A, Krogler-Halpern K, Hanzal E Geburtshilfe Frauenheilkd. 2023; 83(2):165-183.

PMID: 37151735 PMC: 10155200. DOI: 10.1055/a-1933-2647.

Correlation of anorectal symptoms and endoanal ultrasound findings after obstetric anal sphincter injuries (OASIS).

Giroux M, Naqvi N, Alarab M Int Urogynecol J. 2023; 34(9):2241-2247.

PMID: 37071137 DOI: 10.1007/s00192-023-05491-8.

Risk Factors for Anal Continence Impairment Following a Second Delivery after a First Traumatic Delivery: A Prospective Cohort Study.

Marcellier G, Dupont A, Bourgeois-Moine A, Le Tohic A, De Carne-Carnavalet C, Poujade O J Clin Med. 2023; 12(4).

PMID: 36836068 PMC: 9967240. DOI: 10.3390/jcm12041531.

Underdiagnosis of internal anal sphincter trauma following vaginal delivery.

OLeary B, Kelly L, Fitzpatrick M, Keane D Ultrasound Obstet Gynecol. 2023; 61(2):251-256.

PMID: 36722430 PMC: 10108077. DOI: 10.1002/uog.26049.

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