SynthesisBMC health services research2002
Management of obstetric anal sphincter injury: a systematic review & national practice survey.
Synthesis in BMC health services research, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05898945 (Primary Repair of Obstetric Anal Sphincter Injuries), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Primary Repair of Obstetric Anal Sphincter Injuries (OASIS): a Survey of Emergency Surgeons' Experience
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- Risk factors for obstetric anal sphincter injury recurrence: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Pooled it
- Risk factors for recurrent obstetric anal sphincter injury (rOASI): a systematic review and meta-analysis.International urogynecology journal · 2016Pooled it
- Methods of repair for obstetric anal sphincter injury.The Cochrane database of systematic reviews · 2013Pooled it
- Characteristics and management of isolated rectal laceration during vaginal delivery.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Catastrophic pelvic-perineal injuries with traumatic hemipelvectomy following a motorcycle collision: a multidisciplinary reconstruction case report.BMC surgery · 2026Article
- Incidence and Independent Risk Factors for Obstetric Anal Sphincter Injuries: A Four-Year Retrospective Cohort Study from a UK Tertiary Maternity Unit.Journal of clinical medicine · 2026Article
- A UK wide survey of general surgeons' experience of the primary repair of obstetric anal sphincter injuries.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- Diagnosis, management and training in perineal trauma: a UK national survey of obstetricians.International urogynecology journal · 2023Article
- Use of antibiotics in women undergoing correction of an obstetric anal sphincter injury: Results from a national Israeli survey.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Berlin survey on obstetric anal sphincter injury (OASI).Archives of gynecology and obstetrics · 2022Article
- Detailed classification of second-degree perineal tears in the delivery ward: an inter-rater agreement study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- How to do it: delayed sphincteroplasty for obstetric anal sphincter injury.ANZ journal of surgery · 2022Article
- The knowledge and perceptions of healthcare workers regarding obstetrical anal sphincter injuries. A practice audit from a resource-constrained setting.AJOG global reports · 2021Article
- Isolated rectal buttonhole tears in obstetrics: case series and review of the literature.International urogynecology journal · 2021Review
- Identification of obstetric anal sphincter injuries (OASIs) and other lacerations: a national survey of nurse-midwives.International urogynecology journal · 2021Article
- Risk of major labour-related complications for pregnancies progressing to 42 weeks or beyond.BMC medicine · 2021Article
- A surgical technique for secondary repair of obstetric anal sphincter injuries; sphinctero-vagino-perineoplasty.Turkish journal of obstetrics and gynecology · 2018Article
- Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury.International urogynecology journal · 2018Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aim to establish the evidence base for the recognition and management of obstetric anal sphincter injury (OASI) and to compare this with current practice amongst UK obstetricians and coloproctologists.
methodsA systematic review of the literature and a postal questionnaire survey of consultant obstetricians, trainee obstetricians and consultant coloproctologists was carried out.
resultsWe found a wide variation in experience of repairing acute anal sphincter injury. The group with largest experience were consultant obstetricians (46.5% undertaking > or = 5 repairs/year), whilst only 10% of responding colorectal surgeons had similar levels of experience (p < 0.001). There was extensive misunderstanding in terms of the definition of obstetric anal sphincter injuries. Overall, trainees had a greater knowledge of the correct classification (p < 0.01). Observational studies suggest that a new 'overlap' repair using PDS sutures with antibiotic cover gives better functional results. However, our literature search found only one randomised controlled trial (RCT) on the technique of repair of OASI, which showed no difference in incidence of anal incontinence at three months. Despite this, there was a wide variation in practice, with 337(50%) consultants, 82 (55%) trainees and 80 (89%) coloproctologists already using the 'overlap' method for repair of a torn EAS (p < 0.001). Although over 50% of colorectal surgeons would undertake long-term follow-up of their patients, this was the practice of less than 10% of obstetricians (p < 0.001). Whilst over 70% of coloproctologists would recommend an elective caesarean section in a subsequent pregnancy, only 22% of obstetric consultants and 14% of trainees (p < 0.001).
conclusionAn agreed classification of OASI, development of national guidelines, formalised training, multidisciplinary management and further definitive research is strongly recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.