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Introduction and Hypothesis <p>Obstetric anal sphincter injuries (OASIs) are severe perineal lacerations, which have a significant impact on quality of life. The rate of OASIs has been increasing worldwide due to improved awareness, recognition, and reporting. When these women conceive again, they are faced with a dilemma regarding the most appropriate mode of delivery. Although counselling about mode of delivery guides women’s decisions, there is a large variation in clinical practice and advice provided to women worldwide. To date, limited literature is available to guide counselling for an optimal mode of delivery of subsequent pregnancy post-OASIs.</p> Materials and Methods <p>A working subcommittee from the International Urogynaecological Association (IUGA) Innovation, Research, and Development (I, R&amp;D) Committee was created. A literature review was performed to produce a draft, which focused on the recommended mode of subsequent delivery for women with previous OASIs. This document was then evaluated by the entire IUGA I, R&amp;D Committee and revisions were implemented. This review examined the impact of subsequent mode of delivery on pelvic floor functions, overall quality of life, and women’s regret regarding their chosen delivery mode. This work represents a narrative review combined with expert opinion, rather than a systematic review or formal guideline.</p> Results <p>In this opinion paper, the R&amp;D Committee provides guidance regarding the assessment and management of women affected by OASIs and summarises the evidence-based recommendations for the mode of subsequent delivery based on the currently available literature.</p> Conclusion <p>Postpartum faecal incontinence is multifactorial. A comprehensive assessment by an expert clinician using available resources is recommended to guide an informed decision using a collaborative approach regarding the preferred mode of subsequent delivery post OASIs.</p>

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Mode of Subsequent Delivery After Obstetric Anal Sphincter Injuries (OASIs)

  • 期刊论文

  • 发表日期：

    2026年6月2日

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  • May Alarab,
  • Swati Jha,
  • Fernanda Pipitone,
  • Laura Cattani,
  • Adi Yehude Weintraub,
  • Maria Giroux,
  • Abdul H. Sultan

摘要

Introduction and Hypothesis

Obstetric anal sphincter injuries (OASIs) are severe perineal lacerations, which have a significant impact on quality of life. The rate of OASIs has been increasing worldwide due to improved awareness, recognition, and reporting. When these women conceive again, they are faced with a dilemma regarding the most appropriate mode of delivery. Although counselling about mode of delivery guides women’s decisions, there is a large variation in clinical practice and advice provided to women worldwide. To date, limited literature is available to guide counselling for an optimal mode of delivery of subsequent pregnancy post-OASIs.

Materials and Methods

A working subcommittee from the International Urogynaecological Association (IUGA) Innovation, Research, and Development (I, R&D) Committee was created. A literature review was performed to produce a draft, which focused on the recommended mode of subsequent delivery for women with previous OASIs. This document was then evaluated by the entire IUGA I, R&D Committee and revisions were implemented. This review examined the impact of subsequent mode of delivery on pelvic floor functions, overall quality of life, and women’s regret regarding their chosen delivery mode. This work represents a narrative review combined with expert opinion, rather than a systematic review or formal guideline.

Results

In this opinion paper, the R&D Committee provides guidance regarding the assessment and management of women affected by OASIs and summarises the evidence-based recommendations for the mode of subsequent delivery based on the currently available literature.

Conclusion

Postpartum faecal incontinence is multifactorial. A comprehensive assessment by an expert clinician using available resources is recommended to guide an informed decision using a collaborative approach regarding the preferred mode of subsequent delivery post OASIs.