Mode of delivery following an OASIS and caesarean section rates

European Journal of Obstetrics, Gynecology, and Reproductive Biology
Charlotte CassisEdward Morris

Abstract

While the rate of obstetric anal sphincter injury (OASIS) is increasing, there is a lack of evidence on how best to advise women on mode of delivery (MOD) afterwards. The objectives of this study were to assess the clinical value of bowel symptoms, endoanal ultrasound and anorectal manometry in the management of pregnancies after an OASIS and evaluate the performance of different algorithms. This was a retrospective analysis of prospectively collected data in a university hospital perineal clinic. Women with OASIS undergoing endoanal ultrasound scan (EAUS) and anorectal manometry (AM) were included in this study (all women with an OASIS, except the asymptomatic 3a tears). A number of published algorithms were theoretically applied in this cohort to define recommended MOD after an OASIS. Out of the 233 women included in the study, 51 (21.9%) were symptomatic, 141 (60.5%) had persistent sphincter defects on EAUS and 124 (53.2%) had abnormal AM. One asymptomatic and five symptomatic women were found to have isolated internal anal sphincter (IAS) defects without external anal sphincter (EAS) defects. There were no women with low resting pressure and normal incremental squeeze pressure. The application of the algorithm requiring onl...Continue Reading

Citations

Apr 24, 2020·Female Pelvic Medicine & Reconstructive Surgery·Cecilia K WieslanderSarah A Collins
Jul 4, 2020·International Urogynecology Journal·Osanna Yee Ki WanRanee Thakar
Dec 3, 2020·International Urogynecology Journal·Nicola Adanna OkeahialamAbdul H Sultan
Jan 6, 2021·International Urogynecology Journal·Aurore FehlmannMarie-Eve Clermont
May 15, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Annika TaithongchaiAbdul H Sultan

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