Evidence map›Paper›PMID 42616107›Full record

ArticleInternational urogynecology journal2026

Perineal Trauma and Obstetric Anal Sphincter Injuries (OASIs) in the United Kingdom: National Trends and Practice Changes Over a Decade.

Nicola Adanna Okeahialam, Ranee Thakar, Abdul H Sultan

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Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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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

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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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

3 authors.

Nicola Adanna OkeahialamSt Mary's Hospital, Manchester, UK.
Ranee ThakarSt George's University of London, London, UK.
Abdul H SultanBrunel University of London, London, UK. abdulsultan@nhs.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisOASIs affect 6.1% of primiparous and 1.7% of multiparous women in the UK. However, rates of OASI increased threefold between 2000 and 2012. This study aimed firstly to evaluate the current incidence and management of perineal trauma, including mode of birth, OASI and episiotomy in UK maternity units and secondly to monitor temporal trends since the previous national survey.

methodsFreedom of information requests were sent to all UK maternity units requesting data on births between January 2024 and January 2025. Data from the 2009-2010 survey were re-analysed to compare the OASI, episiotomy, operative vaginal birth, and cesarean section (CS) rates at both time points.

resultsOne hundred sixty-one of 268 units (59.7%) responded, including 469,744 births (78.9% of the total births). The median OASI rate was 3.1% (0-12.5%), affecting 6.4% of primiparous women and 1.2% of multiparous women (p < 0.001). Between 2009 and 2025, the odds of a forceps-assisted birth (OR 1.07 [95% CI 1.04-1.09]), OASI (OR 1.15 [95% CI 1.05-1.28]), and CS (OR 1.07 [95% CI 1.04-1.09]) increased in primiparous women. In multiparous women, the rate of CS alone increased (OR 1.04 [95% CI 1.02-1.06]). Overall, there was no change in vacuum-assisted births or episiotomy rates.

conclusionsThis survey provides an update of the incidence of OASI in the UK, identifying an increase in forceps use and OASI incidence in primiparous women. This supports the need for further targeted strategies to reduce OASI, including enhanced training and support for vacuum-assisted births, and appropriate use of mediolateral episiotomy with forceps-assisted births.

Indexed as

Mediolateral episiotomyObstetric anal sphincter injuryOperative vaginal birthPerineal trauma

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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.