Introduction Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence among women of childbearing age. OASI causes significant maternal morbidity in the postpartum period. Overall reported risk of obstetric anal sphincter is 1% of all vaginal deliveries. Obstetric anal sphincter injury (OASI) encompasses both third and fourth degree tears. A third degree tear is the partial or complete disruption of the anal sphincter muscles which may involve either or both the external (EAS) and internal sphincters (IAS) muscles with a fourth degree tear involving a breach of the rectal mucosa.
Aims and Methodology The aim of the audit was to determine the incidence of OASI at Borders General Hospital in comparison with published literature and standard and also to determine the compliance of the unit's management of OASI with the RCOG guideline.
The audit was retrospective and examined case notes of all patients sustaining third and fourth degree tear after vaginal delivery from January 2004 –December 2009. Seventy-three out of a total of 86 case notes were obtained and analysed.
Discussions and Conclusions Management of OASI was overall compliant with RCOG guideline standards. The incidence as at 2009 was 2.6 %. This could have be as a result of increased recognition of OASI nevertheless it is still too high and concrete steps should be taken to reduce this. A significant number of repairs were performed in the room under local anaesthesia, not in keeping with RCOG guidelines and attempts should be made to discontinue this practice.
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