{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:55:47Z","timestamp":1780732547268,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate trends in the incidence of women with obstetric anal sphincter injuries (OASIS) over a 10\u2010year period comparing spontaneous vaginal delivery (SVD) and operative vaginal delivery (OVD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was performed in which all women who underwent vaginal delivery over a 10\u2010year period (<jats:italic>n<\/jats:italic>\u2009=\u200986\u2009242, 2009\u20132018) at the Rotunda Hospital were reviewed. The overall incidence of OASIS was compared with incidence rates stratified by parity and type of vaginal birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 10\u2010year vaginal delivery rate was 69% (<jats:italic>n<\/jats:italic>\u2009=\u200959\u2009187) where 24\u2009580 women (42%) were primiparous and 34\u2009607 women (58%) were multiparous. SVD rate was 74% and OVD rate was 26%. The overall incidence of OASIS was 2.9%. The incidence of OASIS in OVD was 5.5% and the incidence in SVD was 2%. Of 498 multipara who sustained OASIS, 366 (73%) had an SVD without episiotomy compared with 14 (3%) who had an episiotomy. There was a significant reduction of OASIS over the 10\u2010year period in primipara who had an OVD but no reduction in the other groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The primiparous OVD group had a significant reduction of OASIS. Continued education around perineal protection and episiotomy at SVD could positively impact further reduction in OASIS, particularly in the SVD groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14877","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T08:34:33Z","timestamp":1685090073000},"page":"888-893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in obstetric anal sphincter injury in spontaneous vaginal delivery versus operative vaginal delivery over a 10\u2010year period: Lessons learned"],"prefix":"10.1002","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7679-0761","authenticated-orcid":false,"given":"Feras","family":"Alkharouf","sequence":"first","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"},{"name":"Department of Obstetrics &amp; Gynaecology, King Abdulaziz Medical City Ministry of National Guard\u2010Health Affairs  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5141-9168","authenticated-orcid":false,"given":"Niamh","family":"Joyce","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deidre","family":"Ward","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Walsh","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeve","family":"Eogan","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Geary","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/135626229900500601"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.09.006"},{"key":"e_1_2_8_4_1","article-title":"Methods of repair for obstetric anal sphincter injury","volume":"12","author":"Fernando RJ","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","volume-title":"Green\u2010top Guideline No 29","author":"Royal College of Obstetricians and Gynaecologists","year":"2015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12363"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0703-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4236\/ojog.2014.46043"},{"key":"e_1_2_8_9_1","unstructured":"The Rotunda Hospital the Rotunda Annual Reports Dublin 2009\u20102018."},{"key":"e_1_2_8_10_1","article-title":"Selective versus routine use of episiotomy for vaginal birth","volume":"2","author":"Jiang H","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_11_1","volume-title":"WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience","year":"2018"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.03.021"},{"key":"e_1_2_8_13_1","first-page":"30","article-title":"Reducing obstetric anal sphincter injuries (OASIs) at childbirth: a quality improvement project","volume":"125","author":"Mullally A","year":"2018","journal-title":"BJOG"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000478930"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3422-4"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.10.013"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.09.015"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-004-0610-5"},{"issue":"8","key":"e_1_2_8_19_1","first-page":"752","article-title":"Risk factors for third\u2010degree perineal tears in vaginal delivery, with an analysis of episiotomy types","volume":"46","author":"Bodner\u2010Adler B","year":"2001","journal-title":"J Reprod Med"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00835.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.02.008"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03978-x"},{"issue":"12","key":"e_1_2_8_23_1","first-page":"1041","article-title":"Differences in episiotomy technique between midwives and doctors. 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