ArticleBJOG : an international journal of obstetrics and gynaecology2021
Impact of a quality improvement project to reduce the rate of obstetric anal sphincter injury: a multicentre study with a stepped-wedge design.
Article in BJOG : an international journal of obstetrics and gynaecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Effectiveness of education and training programmes to help clinicians assess and classify perineal tears: a systematic review.BMJ open · 2025Pooled it
- Care bundles for women during pregnancy, labour/birth, and postpartum: a scoping review.HRB open research · 2024Pooled it
- Effects of manual perineal protection and pushing techniques used in the second stage of labor on perineal outcomes: a randomized controlled trial of combinations of strategies.BMC pregnancy and childbirth · 2025Trial
- 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
- Prediction of Obstetric Anal Sphincter Injury in Nulliparous Women: Model Development and Temporal Validation.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Female pelvic floor protection-Where do we have to go?Acta obstetricia et gynecologica Scandinavica · 2026Review
- Mode of Subsequent Delivery After Obstetric Anal Sphincter Injuries (OASIs).International urogynecology journal · 2026Review
- 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
- Secular Trends in Recurrent Obstetric Anal Sphincter Injuries among 297,190 Women in Norway: A Cohort Study.International urogynecology journal · 2026Article
- Patient and public involvement (PPI) reporting in maternal and neonatal clinical trials: an exploratory review.Trials · 2026Review
- Development and psychometric evaluation of a scale assessing nursing students' knowledge, attitudes, and practices regarding evidence-based care bundles.BMC nursing · 2026Article
- Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Review
- Establishing the safety of waterbirth for mothers and their babies: the POOL cohort study with nested qualitative component.Health technology assessment (Winchester, England) · 2026Article
- A Comparison of Regulatory Maternity Unit Ratings With Clinical Outcomes and Practice Measures: An Observational Study Using Routinely Collected Data.BJOG : an international journal of obstetrics and gynaecology · 2025Observational
- Mode of delivery and maternal outcome in subsequent delivery after an obstetric anal sphincter injury: a Finnish retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Care pathways and anorectal evaluation for obstetric anal sphincter injury-related incontinence: A UK survey of obstetricians.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Observational
- A Care Bundle Aiming to Reduce the Risk of Obstetric Anal Sphincter Injury: A Survey of Women's Experiences.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Strategies for improving maternal care for ethnic minority women with obstetric anal sphincter injuries in the UK.BMC health services research · 2025Article
- Is the Finnish grip tight enough? A manometric study of two manual perineal protection techniques.Acta obstetricia et gynecologica Scandinavica · 2025Article
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the impact of a care bundle (antenatal information to women, manual perineal protection and mediolateral episiotomy when indicated) on obstetric anal sphincter injury (OASI) rates.
designMulticentre stepped-wedge cluster design.
settingSixteen maternity units located in four regions across England, Scotland and Wales. POPULATION: Women with singleton live births between October 2016 and March 2018.
methodsStepwise region by region roll-out every 3 months starting January 2017. The four maternity units in a region started at the same time. Multi-level logistic regression was used to estimate the impact of the care bundle, adjusting for time trend and case-mix factors (age, ethnicity, body mass index, parity, birthweight and mode of birth).
main outcome measuresObstetric anal sphincter injury in singleton live vaginal births.
resultsA total of 55 060 singleton live vaginal births were included (79% spontaneous and 21% operative). Median maternal age was 30 years (interquartile range 26-34 years) and 46% of women were primiparous. The OASI rate decreased from 3.3% before to 3.0% after care bundle implementation (adjusted odds ratio 0.80, 95% CI 0.65-0.98, P = 0.03). There was no evidence that the effect of the care bundle differed according to parity (P = 0.77) or mode of birth (P = 0.31). There were no significant changes in caesarean section (P = 0.19) or episiotomy rates (P = 0.16) during the study period.
conclusionsThe implementation of this care bundle reduced OASI rates without affecting caesarean section rates or episiotomy use. These findings demonstrate its potential for reducing perineal trauma during childbirth. TWEETABLE ABSTRACT: OASI Care Bundle reduced severe perineal tear rates without affecting caesarean section rates or episiotomy use.
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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.