American College of Obstetricians and Gynecologists (ACOG). Practice bulletin no. 198 Obstet. Gynecol.
2018
Summary:
This guideline from the American College of Obstetricians and Gynecologists offers evidence-based practices for the prevention, diagnosis, and management of obstetric lacerations, including obstetric anal sphincter injuries (OASIS), with a focus on improving maternal outcomes through standardized care.
Keywords:
Obstetric Anal Sphincter Injury (OASIS), third-degree tear, fourth-degree tear, perineal trauma, prevention, diagnosis, repair, vaginal delivery, postpartum recovery, ACOG guidelines.
M. Młyńczak et al., 46th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, USA
2024
Summary:
Early detection of obstetric anal sphincter injuries (OASI) presents a significant challenge due to lack of both effective and practically available diagnostic tools. Thus, ONIRY, a medical device employing electrical impedance spectroscopy combined with machine learning (ML), was introduced to detect OASI quickly after vaginal delivery.
Keywords:
Spectroscopy, analytical models, accuracy, ultrasonic imaging, medical devices, machine learning, impedance, obstetrics, engineering in medicine and biology, Injuries, obstetric anal sphincter injury, impedance spectroscopy, machine learning, diagnostics
Andrews V., Sultan A.H., Thakar R., Jones P.W. BJOG
2006
Summary:
The study investigates the prevalence and detection of occult anal sphincter injuries (OASIS) in women after their first vaginal delivery, highlighting missed diagnoses and the need for improved training in perineal examination and classification.
Keywords:
OASIS, occult injuries, anal sphincter, vaginal delivery, perineal trauma, endoanal ultrasound, diagnostic accuracy, obstetric complications.
Basu M., Smith D., Edwards R., STOMP project team. Eur. J. Obstet. Gynecol. Reprod. Biol.
2016
Summary:
This study examines the effectiveness of the STOMP (Stop Traumatic OASIS Morbidity Project) initiative, a quality improvement program aimed at reducing the incidence of third and fourth-degree obstetric anal sphincter injuries (OASIS) through training and practice adjustments in a UK hospital.
Keywords:
OASIS, obstetric anal sphincter injury, STOMP, third-degree tear, fourth-degree tear, quality improvement, prevention
Borycka-Kiciak K., Młyńczak M., Kiciak A., Pietrzak P., Dziki A. Sci Rep.
2019
Summary:
The study evaluates the use of impedance spectroscopy as a non-invasive method to detect obstetric anal sphincter injuries (OASIS), comparing its accuracy to traditional methods like transanal ultrasound and anorectal manometry.
Keywords:
Obstetric Anal Sphincter Injury (OASIS), Impedance Spectroscopy, Non-invasive Diagnostics, Postpartum Care, Anal Sphincter Assessment, Fecal Incontinence, Ultrasound, Anorectal Manometry, Clinical Accuracy
Clinical Practice Guideline on Care in Normal Childbirth.
2018
Summary:
Clinical practice guidelines for normal childbirth promote evidence-based, cost-effective care and positive birth experiences.
The Spanish Clinical Practice Guidelines on Normal Birth Care provide standardized, evidence-based recommendations for managing labor and delivery, emphasizing minimal intervention and natural birthing processes.
Danish Association of Obstetrics and Gynaecology.
2019
Summary:
The Clinical Practice Guidelines on Obstetric Anal Sphincter Injuries (OASIS) provide recommendations for the diagnosis, treatment, and postoperative management of third- and fourth-degree perineal tears during childbirth.
Keywords:
OASIS, obstetric anal sphincter injury, third-degree tear, fourth-degree tear, perineal trauma, postpartum care, clinical guidelines
Danish Association of Obstetrics and Gynaecology.
2015
Summary:
This guideline addresses methods for preventing Obstetric Anal Sphincter Injuries (OASIS), recommending specific manual perineal protection techniques, episiotomy practices, and patient positioning to reduce OASIS incidence.
Keywords:
OASIS prevention, perineal protection, Norwegian model, episiotomy, manual support, warm compresses, childbirth, patient positioning.
Department for Health and Wellbeing.
2018
Summary:
This South Australian guideline provides clinical recommendations for the management of third- and fourth-degree perineal tears, covering diagnosis, repair techniques, and follow-up care to ensure optimal recovery and minimize complications in future pregnancies.
Keywords:
Third-degree tear, fourth-degree tear, perineal trauma, obstetric anal sphincter injury (OASIS), diagnosis, repair, postnatal care, South Australia, perinatal guidelines.
Ducarme G., Pizzoferrato A.C., de Tayrac R., et al. J. Gynecol. Obstet. Hum. Reprod
2019
Summary:
The CNGOF Clinical Practice Guidelines on Perineal Prevention and Protection in Obstetrics analyze interventions during pregnancy and delivery to prevent obstetric anal sphincter injuries (OASIS) and related pelvic floor complications. These guidelines provide evidence-based recommendations on perineal care practices, including the role of episiotomy, manual support, and postpartum follow-up for perineal injury prevention.
Keywords:
Obstetric anal sphincter injury (OASIS), perineal trauma, episiotomy, prevention, perineal protection, pelvic floor
Dudding T.C., Vaizey C.J., Kamm M.A. Ann. Surg.
2008
Summary:
The review article on Obstetric Anal Sphincter Injury (OASIS) examines the incidence, risk factors, and management strategies for sphincter injuries sustained during childbirth. It highlights both immediate and long-term complications, such as fecal incontinence, and provides insights into the importance of proper diagnosis, prevention, and repair methods to improve outcomes for affected women.
Keywords:
Obstetric anal sphincter injury, OASIS, fecal incontinence, risk factors, perineal trauma, sphincter repair, endoanal ultrasonography.
Fernando R.J., Sultan A.H., Radley S., et al. BMC Health Serv Res.
2002
Summary:
This article reviews evidence on best practices for managing obstetric anal sphincter injuries (OASIs) and highlights variations in UK practices, calling for standardized guidelines and enhanced training to improve patient outcomes.
Keywords:
OASI, management, best practices, UK, guidelines, training
Frost J., Gundry R., Young H., Naguib A. Int. J. Gynaecol. Obstet.
Summary:
This study evaluates the impact of a multidisciplinary training program in perineal care during labor on reducing the incidence of obstetric anal sphincter injuries (OASIs). Findings indicate that incorporating targeted perineal care techniques into mandatory staff training can significantly lower OASI rates, highlighting the importance of standardized training in improving patient outcomes.
Keywords:
OASI, perineal care, multidisciplinary training, obstetric anal sphincter injury, childbirth, prevention, patient outcomes
Guzmán Rojas R.A., Salvesen K.Å., Volløyhaug I. Ultrasound Obstet. Gynecol.
2018
Summary:
This study examines the prevalence of anal sphincter defects and fecal incontinence 15-24 years post-childbirth, associating outcomes with different delivery modes. Findings show that forceps delivery significantly increases the risk of long-term anal sphincter injury and fecal incontinence, with many injuries remaining undetected at the time of delivery.
Keywords:
Anal sphincter defect, fecal incontinence, OASIS, forceps delivery, long-term follow-up, transperineal ultrasound.
Guzman Rojas R.A., Shek K.L., Langer S.M., Dietz H.P. Ultrasound Obstet. Gynecol.
2013
Summary:
This study investigates the prevalence and risk factors associated with obstetric anal sphincter injuries (OASIs) in primiparous women, using transperineal ultrasound for assessment. Findings reveal a high rate of undiagnosed OASIs, particularly following forceps deliveries, underscoring the need for improved diagnostic training for labor ward staff.
Keywords:
OASI, prevalence, risk factors, primiparous women, transperineal ultrasound, forceps delivery, undiagnosed trauma
Harvey M.A., Pierce M., Alter J.E., et al. J. Obstet. Gynaecol. Can.
2015
Summary:
This clinical guideline from the Society of Obstetricians and Gynaecologists of Canada (SOGC) provides recommendations for the prevention, diagnosis, and repair of obstetric anal sphincter injuries (OASIS). It includes guidance on identifying risk factors, optimal repair techniques, and postoperative care to minimize long-term complications like anal incontinence and rectovaginal fistula.
Keywords:
Obstetric anal sphincter injury, OASIS, prevention, diagnosis, repair techniques, postpartum care, anal incontinence
Jorge J.M., Wexner S.D.
1993
Summary:
This article explores the etiology and management of fecal incontinence, discussing its multifactorial causes and various therapeutic approaches, including biofeedback, sphincteroplasty, and other surgical and non-surgical options. It highlights the importance of physiological assessment in determining effective treatments for improved patient outcomes.
Keywords:
Fecal incontinence, etiology, management, biofeedback, sphincteroplasty, anorectal physiology, treatment options
Krissi H., Aviram A., Hiersch L., et al. Int. J. Colorectal Dis.
2016
Summary:
This study evaluates the effectiveness of a structured hands-on workshop on reducing the over-detection rate of obstetric anal sphincter injuries (OASIs) among healthcare providers. Findings indicate that targeted training in proper OASI diagnosis and repair techniques can significantly improve diagnostic accuracy and reduce unnecessary interventions.
Keywords:
OASI, obstetric anal sphincter injury, hands-on workshop, over-detection, diagnostic accuracy, perineal trauma
(S2k-Level, AWMF Registry No. 015/079, December 2020). Kropshofer SA., Aigmüller T., Beilecke K., et al. Geburtshilfe Frauenheilkd.
2022
Summary:
This guideline, developed by the German, Austrian, and Swiss Societies for Gynecology and Obstetrics, provides comprehensive recommendations for the management of third- and fourth-degree perineal tears sustained during vaginal delivery. The focus is on optimal diagnostic procedures, repair techniques, and post-operative care to minimize both immediate and long-term complications.
Keywords:
Perineal tear, third-degree tear, fourth-degree tear, OASI, obstetric injury, postpartum care, surgical repair
Lindqvist M., Persson M., Nilsson M. Midwifery
2018
Summary:
This Swedish qualitative study explores women’s experiences two months after sustaining an obstetric anal sphincter injury (OASIS) during childbirth. The findings reveal that severe pain, psychological distress, and limited healthcare support contribute to significant challenges in recovery, with many women describing their postpartum period as “a worse nightmare than expected.”
Keywords:
OASIS, obstetric anal sphincter injury, postpartum recovery, psychological distress, qualitative study, perineal trauma
Marty N., Verspyck E. Gynecol. Obstet. Fertil. Senol.
2018
Summary:
The document is a French clinical practice guideline from the CNGOF (Collège National des Gynécologues et Obstétriciens Français), focusing on obstetric perineal tears and episiotomy techniques. It provides recommendations for preventing and managing perineal trauma during childbirth, including episiotomy procedures, perineal tear classifications, and optimal repair techniques to reduce complications and promote recovery.
Keywords:
CNGOF, perineal tears, episiotomy, obstetric guidelines, childbirth, perineal trauma prevention, repair techniques
Młyńczak M., Rosoł M., Spinelli A., Dziki A., Wlaźlak E., Surkont G., Krzycka M., Pająk P., Dziki Ł., Mik M., Borycka K. Appl. Sci.
2021
Summary:
This study explores the use of impedance spectroscopy via the ONIRY probe for early detection of obstetric anal sphincter injuries (OASI) post-childbirth. The ONIRY device demonstrated high accuracy compared to traditional methods, suggesting potential for widespread, non-invasive OASI diagnostics in maternity settings.
Keywords:
OASI, impedance spectroscopy, ONIRY, early detection, childbirth, non-invasive diagnostics, fecal incontinence
Nilsson I.E.K., Åkervall S., Molin M., et al. Am. J. Obstet. Gynecol.
2021
Summary:
This study investigates the long-term impact of one or two obstetric anal sphincter injuries (OASIs) on fecal incontinence over two decades. Results indicate that women with repeated OASIs face a significantly higher risk of fecal incontinence as they age, with cumulative effects leading to worsening symptoms and reduced bowel control, especially after the age of 52.
Keywords:
OASI, fecal incontinence, long-term effects, cumulative impact, aging, bowel control, pelvic floor trauma
O’Leary B.D., Kelly L., Fitzpatrick M., Keane D.P. Ultrasound Obstet. Gynecol.
2023
Summary:
This study highlights the frequent underdiagnosis of internal anal sphincter (IAS) trauma following vaginal delivery. Using endoanal ultrasound, it reveals that IAS injuries are often missed in women with Grade 3a/3b tears, impacting long-term outcomes like fecal incontinence and underscoring the need for accurate diagnosis in perineal clinics.
Keywords:
Internal anal sphincter, underdiagnosis, OASI, endoanal ultrasound, fecal incontinence, vaginal delivery, perineal trauma
Oberwalder M., Connor J., Wexner S.D. Br. J. Surg.
2003
Summary:
This meta-analysis assesses the incidence and impact of obstetric anal sphincter injuries (OASIs) diagnosed by endoanal ultrasound after vaginal delivery. Findings reveal a high rate of both symptomatic and asymptomatic sphincter defects, underscoring the importance of early detection and improved diagnostic accuracy to reduce the long-term risk of fecal incontinence.
Keywords:
OASI, anal sphincter injury, meta-analysis, endoanal ultrasound, fecal incontinence, postpartum trauma
Orlando A., Thomas G., Murphy J., et al. Colorectal. Dis.
2024
Summary:
This systematic review and meta-analysis aimed to define the incidence of obstetric anal sphincter injuries during vaginal delivery.
Keywords:
Assisted delivery; incidence of oasis; instrumental delivery; instrumental vaginal delivery; oasis; vaginal delivery.
Roper J.C., Amber N., Wan O.Y.K., et al. Int. Urogynecol. J.
2020
London: RCOG Press
2015
Summary:
This document is a guideline from Queensland Health focused on perineal care, covering all stages from prenatal risk reduction to postnatal recovery. It includes recommendations on assessment, repair, and care techniques for perineal injuries, aiming to optimize maternal health outcomes and support women with varying levels of trauma, including obstetric anal sphincter injuries (OASIS).
Keywords:
Perineal care, perineal injury, OASIS, prenatal care, postnatal recovery, obstetric guidelines, maternal health
Royal College of Physicians of Ireland. Institute of obstetricians and gynaecologists and, directorate of clinical strategy and programmes, health service executive.
2012
Summary:
This Irish guideline provides detailed recommendations for the management of obstetric anal sphincter injuries (OASIs), including diagnosis, optimal repair techniques, post-operative care, and long-term follow-up. It emphasizes training for healthcare professionals, ensuring accurate repair, and supportive postpartum care to prevent complications and improve patient outcomes.
Keywords:
Obstetric anal sphincter injury, OASI, perineal trauma, repair techniques, post-operative care, Irish guidelines, long-term follow-up
Sideris M., McCaughey T., Hanrahan J.G., et al. Eur. J. Obstet. Gynecol. Reprod. Biol
2020
Summary:
This meta-analysis evaluates the risk of obstetric anal sphincter injuries (OASIs) and their association with postpartum anal incontinence. It underscores the importance of accurate OASI diagnosis and effective repair techniques to mitigate long-term incontinence risks, providing evidence for improved clinical guidelines in obstetric care.
Keywords:
Obstetric anal sphincter injury, OASI, anal incontinence, postpartum, meta-analysis, endoanal ultrasound, repair techniques
Spinelli A., Laurenti V., Carrano FM., Gonzalez-Díaz E., Borycka-Kiciak K. J Clin Med.
2021
Summary:
This review provides an overview of current diagnostic and treatment approaches for obstetric anal sphincter injuries (OASIs), focusing on recent advances in early detection techniques and individualized care strategies. It highlights the importance of accurate, timely diagnosis to prevent long-term complications like fecal incontinence and discusses the roles of ultrasound, MRI, and impedance spectroscopy in assessment.
Keywords:
Obstetric anal sphincter injury, OASI, diagnosis, treatment, ultrasound, MRI, impedance spectroscopy, fecal incontinence
Sultan A., Thakar R., Lewicky-Gaupp C. Wyd. 2. Springer
2024
Summary:
This comprehensive textbook covers the diagnosis, management, and prevention of pelvic floor, perineal, and anal sphincter trauma associated with childbirth. It provides in-depth information on anatomy, injury mechanisms, treatment options, and rehabilitation techniques, making it an essential resource for healthcare providers involved in maternal care and obstetric trauma.
Keywords:
Pelvic floor trauma, perineal injury, obstetric anal sphincter injury (OASI), childbirth, diagnosis, management, prevention, rehabilitation
Sultan A.H. AVMA Med. Legal J. (Clinical Risk)
1999
Summary:
This article provides an in-depth discussion on the causes, diagnosis, and management of obstetric anal sphincter injuries (OASIs) and their impact on long-term outcomes like fecal incontinence. It emphasizes the importance of accurate diagnosis, preventive measures, and repair techniques, highlighting advances in perineal trauma management and the role of endoanal ultrasound in detecting occult injuries
Keywords:
Obstetric anal sphincter injury, OASI, fecal incontinence, diagnosis, prevention, perineal trauma, endoanal ultrasound
Walsh K.A., Grivell R.M. Cochrane Database Syst. Rev.
2015
Summary:
This Cochrane systematic review assesses the effectiveness of using endoanal ultrasound (EAUS) in reducing the risk of complications from obstetric anal sphincter injuries (OASIs) after vaginal birth. The review finds that EAUS before perineal repair improves detection and reduces severe anal incontinence but may increase short-term perineal pain, suggesting a need for further studies to confirm its benefits in clinical settings.
Keywords:
Endoanal ultrasound, obstetric anal sphincter injury, OASI, vaginal birth, perineal repair, anal incontinence, maternal health, Cochrane review
Packet B., Page A.-S., Cattani L., Bosteels J., Deprest J., Richter J. Ultrasound Obstet Gynecol
2023
Summary:
This study systematically reviews predictive factors for obstetric anal sphincter injury (OASI) in primiparous women, identifying significant risks such as gestational age, labor augmentation, forceps use, shoulder dystocia, and episiotomy. Findings underscore the importance of early detection and tailored preventative measures to reduce the incidence of OASI.
Keywords:
Obstetric anal sphincter injury, OASI, predictive factors, primiparous women, ultrasound, episiotomy, forceps, labor augmentation
