ArticleInternational urogynecology journal2020
The consequences of undiagnosed obstetric anal sphincter injuries (OASIS) following vaginal delivery.
Article in International urogynecology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Effectiveness of education and training programmes to help clinicians assess and classify perineal tears: a systematic review.BMJ open · 2025Pooled it
- OASI2: a cluster randomised hybrid evaluation of strategies for sustainable implementation of the Obstetric Anal Sphincter Injury Care Bundle in maternity units in Great Britain.Implementation science : IS · 2021Trial
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Mode of Subsequent Delivery After Obstetric Anal Sphincter Injuries (OASIs).International urogynecology journal · 2026Review
- Feasibility and reproducibility of a novel introital exo-anal ultrasound approach for assessment of the external anal sphincter.Acta obstetricia et gynecologica Scandinavica · 2026Article
- The Use of Transperineal and Endoanal Ultrasound in Diagnosis and Management of Obstetric Anal Sphincter Injuries (OASIs): A Narrative Review from a Gynecologic Perspective.Diagnostics (Basel, Switzerland) · 2026Review
- Role of Ultrasound in the Evaluation of Women with Obstetric Anal Sphincter Injuries: Narrative Review.International urogynecology journal · 2026Review
- Prevalence and Predictors of Anal Sphincter Injuries in Primipara with Vacuum-Assisted Deliveries.International urogynecology journal · 2025Observational
- Diagnosis, management and training in perineal trauma: a UK national survey of obstetricians.International urogynecology journal · 2023Article
- Prevalence of Perineal Tear Peripartum after Two Antepartum Perineal Massage Techniques: A Non-Randomised Controlled Trial.Journal of clinical medicine · 2021Article
- Women's experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma.International urogynecology journal · 2021Article
- Effectiveness of structured education and training in perineal wound assessment and repair for midwives and midwifery students: A review of the literature.European journal of midwifery · 2021Review
- Review of available national guidelines for obstetric anal sphincter injury.International urogynecology journal · 2020Review
- A one-stop perineal clinic: our eleven-year experience.International urogynecology journal · 2020Observational
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisWe aimed to compare anal and urinary incontinence symptoms and anal manometry between women with undiagnosed obstetric anal sphincter injuries (OASIS) and women who had OASIS diagnosed and repaired.
methodsThis was a matched retrospective cohort study. Each missed OASI was matched with a diagnosed OASI for severity [minor (3a/b) or major (3c)], parity and length of follow-up. Women completed the modified St Mark's Incontinence Score and International Consultation on Incontinence Questionnaire. Women with OASIS or those without OASIS but with anal incontinence symptoms were seen in perineal clinic for perineal examinations, anorectal manometry and three-dimensional endoanal ultrasound 8-12 weeks postnatally or in a subsequent pregnancy.
resultsForty missed OASIS were matched with 40 recognised OASIS (16 3a/b; 24 3c). The median modified St Mark's scores were higher for missed tears [11 (4, 15) vs. 1 (0, 4), p < 0.001] as well as the urinary incontinence scores [4 (0, 6) vs. 0 (0, 2), p = 0.01] than for the control group. Missed OASIS patients had a shorter perineal body [1.6 ± 1.3 vs. 2.4 ± 0.8, p = 0.009]. All missed OASIS had larger defects on endoanal ultrasound. One in four missed OASIS required further surgery [aOR 4.1 (95% CI 1.0-16.3), p = 0.04] and almost all needed colorectal input [aOR 24.1 (95% CI 7.3-80.0), p < 0.0001]. There were no differences in anal manometry.
conclusionsWomen with symptomatic missed OASIS are compromised in terms of anal and urinary incontinence symptoms, sphincter defect size and perineal body size requiring additional colorectal input. This highlights the importance of preventing OASIS and perseverance with training to diagnose OASIS.
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