Management of Acute Obstetric Anal Sphincter Injuries (OASIs)

As OASIs remain the most common cause of faecal incontinence in women, it is imperative that an accurate diagnosis is made in the immediate postpartum period, followed by an appropriate repair. As the initial repair is associated with the best outcome, obstetricians need to be skilled in the accurate assessment and techniques of repair. This chapter provides a step-by-step approach for this, ensuring restoration of the high-pressure zone of the anal canal, which is the best predictor of continence. The importance of intra-operative and post-operative management with clear documentation is highlighted. Finally, the best available evidence is provided for counselling women regarding mode of birth after a previous OASI.