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Guideline No. 457: Obstetrical Anal Sphincter Injuries (OASIS) Part I: Prevention, Recognition, and Immediate
Dobrochna Globerman1, Alison Carter Ramirez2, Maryse Larouche3
1Winnipeg, MB.
This guideline offers updated strategies for recognizing, preventing, and managing obstetrical anal sphincter injuries (OASIS) during vaginal delivery. Implementing these recommendations can improve patient outcomes and reduce long-term complications.
Area of Science:
- Obstetrics and Gynecology
- Surgical Procedures
- Patient Care
Background:
- Obstetrical anal sphincter injuries (OASIS) are a significant concern in vaginal deliveries.
- Effective recognition and management are crucial to minimize short- and long-term complications.
Purpose of the Study:
- To provide updated guidance on the recognition, prevention, and management of OASIS.
- To promote optimal primary repair and immediate postpartum care for OASIS.
Main Methods:
- Comprehensive literature search of multiple databases (PubMed, Embase, Cochrane Library) from 2014-2023.
- Inclusion of systematic reviews, meta-analyses, RCTs, observational studies, and clinical practice guidelines.
- Evidence quality and recommendation strength assessed using the GRADE approach.
Main Results:
- Preventive strategies like controlled fetal head delivery and judicious episiotomy use are associated with lower OASIS rates.
- Appropriate diagnosis, repair, antibiotic prophylaxis, and functional management decrease complications.
- Implementation can enhance detection, prevention, and management, reducing the burden of OASIS.
Conclusions:
- Updated recommendations for obstetrical care providers on OASIS recognition, prevention, and management.
- Standardized classification of OASIS will improve research efforts.
- Adherence to guidelines aims to improve patient outcomes and reduce sequelae.
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