Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Ginath, Shimon; Mizrachi, Yossi; Bar, Jacob; Condrea, Alexander; Kovo, Michal

doi:10.5041/rmmj.10295

Cited by 24 publications

(22 citation statements)

References 21 publications

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“…The prevalence of OASI in studies from around the world ranges from 0.1% to 19% [8] Figure 1 Flow chart to demonstrate complete patient numbers in the study population. obesity and instrumental deliveries.…”

Section: Discussionmentioning

confidence: 99%

The impact of a nationwide hands‐on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

et al. 2020

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Section: Discussionmentioning

confidence: 99%

The impact of a nationwide hands‐on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

et al. 2020

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“…The low incidence in Finland might be due to the practice of manually supporting the perineum when the baby’s head is crowning through the vaginal introitus [ 11 ]. In Israel, the incidence of OASIS has remained low, in spite of increased detection rate, due to the incorporation of manual perineal protection, the avoidance of midline episiotomy and the fact that the use of forceps is almost extinct [ 26 ]. In our study population, the recurrence rate of OASIS was 5%, which was similar to previous findings [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of primary anal sphincter repair after obstetric injury and evaluation of a novel three-choice assessment

et al. 2018

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BackgroundThe aim of the present study was to evaluate the subjective outcome of primary repair of obstetric anal sphincter injury (OASIS) at 6 months, the factors associated with the symptoms of anal incontinence (AI), and the role of a simple survey consisting in one question with three answer choices, combined with the Wexner incontinence score for the assessment of this patient population.MethodsA retrospective cohort study was conducted on patients with third- or fourth-degree OASIS operated on between January 2007 and December 2013 inclusive at Tampere University Hospital, Finland. At 6 months, the patients were asked to report their Wexner’s score as well as the three-choice assessment regarding AI symptoms. Based on this assessment, the patients were divided into three groups: those, asymptomatic, those with mild symptoms who did not want further treatment and those with severe symptoms who were willing to undergo further evaluation and treatment.ResultsThere were 325 patients (median age 30 years). A total of 310 patients answered the questionnaire. Of which, one hundred and ninety-eight (63.9%) patients were asymptomatic, 85 (27.4%) had mild AI, and 27 (8.7%) experienced severe symptoms. There was no statistical difference in the results between the two techniques used (overlapping vs. end-to-end), or the stage of specialization of the operating physician. Persistent symptoms were associated with instrumental vaginal delivery (OR 2.12, 95% CI 1.32–3.41), severity of the injury (OR 1.64, 95% CI 1.20–2.25), and increased maternal age (OR 1.07, 95% CI 1.02–1.13). The correlation between the three-choice symptom evaluation and the Wexner score was good (Spearman’s rho 0.82).ConclusionsAfter 6 months, severe symptoms after OASIS repair were present in 9% of women and were more frequent in older women, women with high-degree tears and after instrumental vaginal delivery. A three-choice assessment of AI symptoms correlated well with the Wexner score and might be useful to triage patients who need further evaluation.

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“…Last, the diagnosis of OASI is subjective and subject to the knowledge and experience of the care provider. High OASI rates can be a signal of overdiagnosis [27], whereas low rates may indicate underdiagnosis [28]. Hence, uniform means of diagnosing OASI across countries are required.…”

Section: Plos Medicinementioning

confidence: 99%

Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study

Seijmonsbergen-Schermers

et al. 2020

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Background Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. Methods and findings In this multinational cross-sectional study, existing data on 4,729,307 singleton births at �37 weeks in 2013 from Finland,

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Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Cited by 24 publications

References 21 publications

The impact of a nationwide hands‐on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

The impact of a nationwide hands‐on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

Outcomes of primary anal sphincter repair after obstetric injury and evaluation of a novel three-choice assessment

Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study

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