Increased Oasis Incidence – Indicator of the Quality of Obstetric Care?

Abstract

SUMMARYIn the era of new molecular, epigenetic and proteomic discoveries, birth canal injuries seem like outdated discussion. A vast increase in the incidence of obstetric anal sphincter injuries (OASIS) has been recorded in the last two decades despite advantages in modern medicine and new obstetric methods. This increase might be attributed to the new classification of perineal injury but also to the new imaging methods, including endoanal sonography, which earlier identifies injuries that previously were considered to be occult and actually underwent unrecognized, and which should have been recognized immediately postpartum. OASIS are third and fourth degree perineal injuries that occur during delivery. The reported incidence of OASIS varies from 0.1% to 10.9%. It is well known that third and fourth degree perineal injuries occur more often in primiparae, and in cases of macrosomic newborn, dorsoposterior position of fetal head and shoulder dystocia. The protective role of episiotomy is controversial. Birth canal injury during delivery can happen to any parturient woman. It is important for obstetricians to have this in mind at every delivery. Repercussions of OASIS are serious and can persist for life. They include emotional, psychological, social, physical and sexual disturbances. Therefore, it is very important to recognize the risk factors, diagnose the injury on time and treat it properly by a multidisciplinary team. Accordingly, it can be concluded that the increased incidence of OASIS is a result of better recognition of the risk factors, reduced rates of unrecognized sphincter injuries, adoption of the new classification and better postpartum imagining methods for detection of occult injuries.

Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life

“…According to our case study, major vaginal injuries were indeed more prevalent among women with high Table 4 Proportion of individuals who scored 3-4 for each item of the CRADI-8 survey Table 5 Proportion of individuals who scored 3-4 for each item of the UDI-6 survey Most of vaginal tears are minor (I and II grade) and heal without consequences [16]. However, injuries involving the anal sphincter affect from 3 to 11% of nullipara women after vaginal birth [5][6][7][8][9][10] and are associated with significant short and long term maternal morbidity. Similarly, in our case history the rate of perineal tears of births registered between 2015 and 2021 was of 2.4% for III and IV degree and of 53% for I and II degree.…”

“…Third-and fourth-degree perineal tears have an incidence in primiparous women of 3-6.5% [5][6][7][8] and are a frequent cause of pelvic floor dysfunction, fecal and urinary incontinence, dyspareunia, and pain with symptoms that can persist for many years after vaginal delivery. Incidence rates vary widely between countries [9], and in England incidence has tripled from 1.8% in 2000 to 5.9% in 2012 [10]. In Italy, the College of Health (https:// www.…”

Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life

“…Third-and fourth-degree perineal tears have an incidence in primiparous women of 3-6.5% [5,6,7,8] and are a frequent cause of pelvic oor dysfunction, fecal and urinary incontinence, dyspareunia, and pain with symptoms that can persist for many years after vaginal delivery. Incidence rates vary widely between Countries [9], and in England incidence has tripled from 1.8% in 2000 to 5.9% in 2012 [10]. In Italy, the College of Health [11] has registered a rate of perineal tears from vaginal births rising between 2000-2018, with a peak of 72% in 2018.…”

Incidencia, complicaciones inmediatas y tempranas de desgarros perineales graves durante el parto en una institución de referencia de atención obstétrica en Medellín, Colombia

“…La ocurrencia de desgarros perineales severos (DPS) se ha descrito hasta en el 8,3 % de los partos, comprometiendo el esfínter anal, con o sin compromiso de la mucosa rectal (1). De acuerdo con la severidad y compromiso de las estructuras anatómicas, los desgarros perineales se consideran severos cuando son de tercer y cuarto grado según la clasificación más aceptada, y se conocen también como OASIS (por sus siglas en inglés, Obstetric Anal Sphincter Injuries) (2,3,4).…”