ArticleCureus2025
Risk Factors, Management, and Follow-Up of Obstetric Anal Sphincter Injuries: An Audit From a UK District General Hospital.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObstetric anal sphincter injuries (OASIs) are a major cause of maternal morbidity. This audit evaluated risk factors, intrapartum management, postoperative care, and follow-up of OASI cases at a UK district general hospital, benchmarking practices against national guidance. METHODOLOGY: Retrospective audit of women who sustained OASI between January 1 and December 31, 2023. Data were extracted from electronic and paper records. Outcomes were assessed against Royal College of Obstetricians and Gynecologists (RCOG) Green-top Guideline No. 29 standards. The prevalence of OASI among total and vaginal deliveries in 2023 was reported.
resultsTwenty-eight women sustained OASI; 23 (82%) were primiparous, and 10 (36%) had an instrumental delivery. Episiotomy was performed in 14 (50%). Perineal support was recorded in 19 (68%). Postoperative care aligned well with standards: antibiotics in 26 cases (93%), physiotherapy referral in 27 (96%), and laxatives in 22 (79%). Gynecology follow-up referral was documented in 21 (75%) cases. OASI prevalence in 2023 was 13.3% of all births and 22.8% of vaginal births at our unit.
conclusionsPrimiparity and instrumental delivery were common risk factors. Immediate postoperative care met most standards, but documentation and follow-up referrals were inconsistent. A structured OASI proforma and standardized referral pathway are recommended to improve continuity of care. Recognition of high-risk women and consistent use of preventive strategies, together with structured counselling for future deliveries, may further improve outcomes.
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