Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors.

Shimon Ginath,Yossi Mizrachi,Michal Kovo,Jacob Bar,Alexander Condrea

doi:10.5041/rmmj.10295

Abstract

Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.1% and 0.6%, out of all vaginal births, which is 10-fold lower than that reported in Europe and the United States. Structured hands-on training in repair of OASIs in seven medical centers in Israel significantly increased the detection rate of third-degree perineal tears. The implementation of such programs is crucial for increasing awareness and detection rates of OASIs following vaginal deliveries.

Highlights

Perineal tears following childbirth are longitudinal, extending from the vulva, and reach and involve the anal sphincter.[1]
The aim of this study is to report the incidence and risk factors of severe perineal tears as published in peer-reviewed studies from Israel
Eight papers were found after the search describing the incidence and risk factors of Obstetric anal sphincter injuries (OASIs) in Israel

Summary

Introduction

Perineal tears following childbirth are longitudinal, extending from the vulva, and reach and involve the anal sphincter.[1] It is of major importance to recognize the full extent of the damage, since repair must be meticulous in order to avoid preventable complications. Perineal tears are classified into four grades according to their extent: 2. 1. First-degree tears include injury to the skin only. 2. Second-degree tears include injury to the perineum involving perineal muscles but not the anal sphincter. 3. Third-degree tears include injury to perineum involving the anal sphincter complex. Third-degree tears are further divided into (i) less than 50% of the external anal sphincter thickness torn, (ii) more than 50% of the external anal sphincter thickness torn, and (iii) internal anal sphincter torn

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