Evidence map›Paper›PMID 31529328›Full record

ArticleInternational urogynecology journal2020

What is the total impact of an obstetric anal sphincter injury? An Australian retrospective study.

Elizabeth Evans, Clorinda Falivene, Kathy Briffa, Judith Thompson, Amanda Henry

Abstract read
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In one paragraph

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 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  18. A one-stop perineal clinic: our eleven-year experience.International urogynecology journal · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elizabeth EvansSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia. lyz@womeninfocusphysio.com.au.ORCID 0000-0002-8750-7183
Clorinda FaliveneSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Kathy BriffaSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Judith ThompsonSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Amanda HenrySchool of Women's and Children's Health, UNSW Medicine, Sydney, New South Wales, Australia.

Funding

The Royal Hospital for Women Foundation 00000
6 · The paper itself

Abstract

introductionMost data on obstetric anal sphincter injury (OASI) reflect short-term (< 12 months) or much longer term (> 10 years) impact. This study aimed to collate the extent of medium-term symptomology (1-6 years) and observe the effect on future birth choices to evaluate the cumulative impact of OASI in affected women.

methodsA retrospective cohort of women affected by OASI completed a questionnaire covering bowel symptomology, sexual function, life impact and future birth choices. A custom-created adverse composite outcome for OASI incorporating effects on daily life, flatal/fecal incontinence and sexual function (OASIACO) was used as a threshold score to identify women with high levels of symptoms.

resultsOf 265 eligible and contactable women, 210 questionnaires were received (response rate 79%) at a mean of 4 years post-OASI. More than half (54%) experienced an OASIACO. A forceps birth (p = 0.03) or more severe grade of tear (p = 0.03) was predictive of OASIACO. One hundred one women had further children, with 48% reporting their delivery choices were impacted, 32% electing a cesarean delivery and 26% shifting to private care. Eighty women (40%) had not given birth again, and 29 (36%) of these indicated their OASI influenced this decision.

conclusionsThe total impact of an OASI on women affected is substantial. More than half experience ongoing symptoms and close to half report an impact on their future birth choices. It follows there would be a consequential load on the healthcare sector, and improved management and prevention programs should be implemented.

Indexed as

Anal CanalFecal IncontinenceAustraliaChildDelivery, ObstetricFemaleHumansPregnancyRetrospective StudiesAnal incontinenceBirth injuryDyspareuniaOASIPerineal tearThird degree tear

Identifiers

PMID31529328
PMCPMC7093361

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Registered trials

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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.