Analysis of clinical characteristics and outcomes of 57 cases with obstetric anal sphincter injuries
Objective Obstetric anal sphincter injuries(OASIS)is a serious complication of vaginal delivery.This study aims to explore the clinical characteristics and perioperative management of patients with OASIS providing refer-ence for clinical management.Methods We reviewed the cases of OASIS during vaginal delivery at the Zhujiang New Town Branch of Guangzhou Women and Children's Medical Center from January 1,2018 to December 31,2022.We summarized the clinical characteristics,perioperative management,and follow-up outcomes.Results The 5-year inci-dence of OASIS was 0.1％(57/40 855),with grade Ⅳ laceration of the perineum accounting for 21.1％(12/57).Primip-ara accounted for 68.4％(39/57)of cases and 17.5％(10/57)were non-anterior occipital deliveries.The episiotomy rate was 38.6％(22/57),the assisted vaginal delivery rates was 29.8％(17/57)and only 4 cases were macrosomia,ac-counting for 7.0％(4/57).One rectal mucosal button-hole injury was diagnosed 28 days after delivery and followed up for six months after repair,resulting in a full recovery.56 cases were diagnosed with OASIS during labor,with 53 re-paired by external anal sphincter end-to-end and three repaired by overlapping.Postoperative intestinal management and broad-spectrum antibiotics were provided.One patient with a grade Ⅳ laceration suffered a rectovaginal fistula,which healed spontaneously after three months of conservative treatment.The remaining patients recovered well.Conclu-sions OASIS often occurs in women with primiparity,vaginal delivery,non-occipital delivery,and macrosomia.Early detection,standardized repair treatment,and perioperative process management are key to successful healing.
obstetric and sphincter injuriesclinical characteristicperioperative managementclinical outcome
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