OASI Wound Complications and Impact on Future Delivery Outcomes

Area of Science:

• Obstetrics and Gynecology
• Urogynecology
• Pelvic Floor Health

Background:

• Perineal wound complications after obstetric anal sphincter injury (OASI) repair can impact pelvic floor function, continence, and sexual health.
• Understanding risk factors for OASI complications is crucial for optimizing future delivery strategies.

Purpose of the Study:

• To identify characteristics associated with wound complications following OASI repair.
• To compare rates of recurrent OASI and perineal wound complications in subsequent vaginal deliveries based on prior complication status.

Main Methods:

• Retrospective cohort study of patients with OASI and subsequent delivery between 2018-2023.
• Wound complications defined as infection, dehiscence, granulation tissue requiring treatment, or surgical revision.
• Statistical analysis using t tests and chi-squared tests to compare outcomes.

Main Results:

• 41.7% of patients experienced wound complications after initial OASI repair; no demographic or obstetric factors were associated.
• In subsequent vaginal deliveries, recurrent OASI (5.5%) and early wound complications (1.1%) were uncommon and not linked to prior complications.

Conclusions:

• Recurrent OASI and wound complications after subsequent vaginal delivery are infrequent in patients managed in a specialized clinic.
• Findings support counseling patients on delivery planning after OASI, suggesting low risk for recurrence.