Risk Factors, Management, and Follow-Up of Obstetric Anal Sphincter Injuries: An Audit From a UK District General Hospital
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Obstetric 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. RESULTS: Twenty-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. CONCLUSIONS: Primiparity 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.
Source: Cureus
DOI: 10.7759/cureus.92426
Author: Anushae A Akhtar
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414249488