{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:24:40Z","timestamp":1791390280881,"version":"4.3.3"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T00:00:00Z","timestamp":1568592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T00:00:00Z","timestamp":1568592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Royal Hospital for Women Foundation","award":["00000"],"award-info":[{"award-number":["00000"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Most data on obstetric anal sphincter injury (OASI) reflect short-term (&lt; 12\u00a0months) or much longer term (&gt; 10\u00a0years) impact. This study aimed to collate the extent of medium-term symptomology (1\u20136\u00a0years) and observe the effect on future birth choices to evaluate the cumulative impact of OASI in affected women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of women affected by OASI completed a questionnaire covering bowel symptomology, sexual function, life impact and future birth choices. A custom-created adverse composite outcome for OASI incorporating effects on daily life, flatal\/fecal incontinence and sexual function (OASIACO) was used as a threshold score to identify women with high levels of symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 265 eligible and contactable women, 210 questionnaires were received (response rate 79%) at a mean of 4\u00a0years post-OASI. More than half (54%) experienced an OASIACO. A forceps birth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) or more severe grade of tear (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) was predictive of OASIACO. One hundred one women had further children, with 48% reporting their delivery choices were impacted, 32% electing a cesarean delivery and 26% shifting to private care. Eighty women (40%) had not given birth again, and 29 (36%) of these indicated their OASI influenced this decision.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The total impact of an OASI on women affected is substantial. More than half experience ongoing symptoms and close to half report an impact on their future birth choices. It follows there would be a consequential load on the healthcare sector, and improved management and prevention programs should be implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-019-04108-3","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T11:03:21Z","timestamp":1568631801000},"page":"557-566","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["What is the total impact of an obstetric anal sphincter injury? An Australian retrospective study"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-7183","authenticated-orcid":false,"given":"Elizabeth","family":"Evans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clorinda","family":"Falivene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Briffa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,16]]},"reference":[{"key":"4108_CR1","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1002\/uog.7512","volume":"36","author":"AM Roos","year":"2010","unstructured":"Roos AM, Thakar R, Sultan A. Outcome of primary repair of obstetric anal sphincter injuries (OASIS): does the grade of tear matter? Ultrasound Obstet Gynecol. 2010;36:368\u201374.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"4108_CR2","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00192-010-1134-0","volume":"21","author":"R Tin","year":"2010","unstructured":"Tin R, Schulz J, Gunn B, Flood C, Rosychuk R. The prevalence of anal incontinence in post-partum women following obstetrical anal sphincter injury. Int Urogynecol J. 2010;21:927\u201332.","journal-title":"Int Urogynecol J"},{"key":"4108_CR3","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1111\/j.1463-1318.2007.01445.x","volume":"10","author":"DN Samarasekera","year":"2008","unstructured":"Samarasekera DN, Bekhit MT, Wright Y, et al. Long term anal continence and quality of life following postpartum anal sphincter injury. Color Dis. 2008;10:793\u20139.","journal-title":"Color Dis"},{"issue":"6","key":"4108_CR4","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.1097\/01.AOG.0000246799.53458.bc","volume":"108","author":"H Ritcher","year":"2006","unstructured":"Ritcher H, Fielding J, Bradley C, et al. Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol. 2006;108(6):1394\u2013401.","journal-title":"Obstet Gynecol"},{"key":"4108_CR5","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/j.1471-0528.2004.00400.x","volume":"112","author":"E Fornell","year":"2005","unstructured":"Fornell E, Matthiesen L, Sj\u00f6dahl R, Berg G. Obstetric anal sphincter injury ten years after: subjective and objective long term effects. BJOG. 2005;112:312\u20136.","journal-title":"BJOG"},{"issue":"5","key":"4108_CR6","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1016\/j.ajog.2005.10.796","volume":"194","author":"M Otero","year":"2006","unstructured":"Otero M, Boulvain M, Bianchi D, et al. Women\u2019s heath 18 years after rupture of the anal sphincter during childbirth: II. Urinary incontinence, sexual function, and physical and mental health. Am J Obstet Gynecol. 2006;194(5):1260\u20135.","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"4108_CR7","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s00192-013-2238-0","volume":"25","author":"A Visscher","year":"2014","unstructured":"Visscher A, Lam T, Hart N, Felt-Bersma R. Fecal incontinence, sexual complaints, and anorectal function after third-degree obstetric anal sphincter injury (OASI): 5-year follow-up. Int Urogynecol J. 2014;25(5):607\u201313.","journal-title":"Int Urogynecol J"},{"issue":"4","key":"4108_CR8","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1111\/jan.12005","volume":"69","author":"H Priddis","year":"2013","unstructured":"Priddis H, Dahlen H, Schmied V. Women\u2019s experiences following severe perineal trauma: a meta-ethnographic synthesis. J Adv Nurs. 2013;69(4):748\u201359.","journal-title":"J Adv Nurs"},{"issue":"3\u20134","key":"4108_CR9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1177\/1356262216676131","volume":"22","author":"AH Sultan","year":"2016","unstructured":"Sultan AH, Ritchie A, Mooney G. Obstetric anal sphincter injuries: review of recent medico-legal aspects. Clin Risk. 2016;22(3\u20134):57\u201360.","journal-title":"Clin Risk"},{"issue":"1","key":"4108_CR10","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1177\/1356262213486434","volume":"19","author":"A Anderson","year":"2013","unstructured":"Anderson A. Ten years of maternity claims: an analysis of the NHS litigation authority data - key findings. Clin Risk. 2013;19(1):24\u201331.","journal-title":"Clin Risk"},{"key":"4108_CR11","first-page":"1057","volume":"108","author":"GJ Bugg","year":"2001","unstructured":"Bugg GJ, Kiff ES, Hosker G. A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG. 2001;108:1057\u201367.","journal-title":"BJOG"},{"key":"4108_CR12","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s00192-009-0997-4","volume":"21","author":"K Baessler","year":"2010","unstructured":"Baessler K, O\u2019Neill SM, Maher CF, Battistutta D. A validated self-administered female pelvic floor questionnaire. Int Urogynecol J. 2010;21:163\u201372.","journal-title":"Int Urogynecol J"},{"issue":"3","key":"4108_CR13","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1007\/s00404-011-2003-x","volume":"285","author":"R Kumar","year":"2012","unstructured":"Kumar R, Ooi C, Nicoll A. Anal incontinence and quality of life following obstetric anal sphincter injury. Arch Gynecol Obstet. 2012;285(3):591\u20137.","journal-title":"Arch Gynecol Obstet"},{"key":"4108_CR14","first-page":"955","volume":"92","author":"V Donnelly","year":"1998","unstructured":"Donnelly V, Fynes M, Campbell D, Johnson H, O'Connell R, O'Herlihy C. Obstetric events leading to anal sphincter damage. Obstet Gynecol. 1998;92:955\u201361.","journal-title":"Obstet Gynecol"},{"issue":"12","key":"4108_CR15","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1007\/BF02236202","volume":"42","author":"A Varma","year":"1999","unstructured":"Varma A, Gunn J, Gardiner A, Lindow SW, Duthie GS. Obstetric anal sphincter injury. Dis Colon Rectum. 1999;42(12):1537\u201342.","journal-title":"Dis Colon Rectum"},{"issue":"5","key":"4108_CR16","doi-asserted-by":"publisher","first-page":"e004551","DOI":"10.1136\/bmjopen-2013-004551","volume":"4","author":"HG Dahlen","year":"2014","unstructured":"Dahlen HG, Tracy S, Tracy M, Bisits A, Brown C, Thornton C. Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000\u20132008): a linked data population-based cohort study. BMJ Open. 2014;4(5):e004551.","journal-title":"BMJ Open"},{"issue":"5","key":"4108_CR17","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00404-017-4352-6","volume":"295","author":"A Antonakou","year":"2017","unstructured":"Antonakou A, Papoutsis D, Henderson K, Qadri Z, Tapp A. The incidence of and risk factors for a repeat obstetric anal sphincter injury (OASIS) in the vaginal birth subsequent to a first episode of OASIS: a hospital-based cohort study. Arch Gynecol Obstet. 2017;295(5):1201\u20139.","journal-title":"Arch Gynecol Obstet"},{"key":"4108_CR18","unstructured":"PANDA \u2013 Perinatal Anxiety and Depression Australia. North Fitzroy, Victoria, Australia. \nhttps:\/\/www.panda.org.au\n\n Accessed 25 Nov 2017."},{"key":"4108_CR19","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.gyobfe.2016.05.007","volume":"44","author":"D Desseauve","year":"2016","unstructured":"Desseauve D, Proust S, Carlier-Guerin C, Rutten C, Pierre F, Fritel X. Evaluation of long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI) at least one year after delivery: a retrospective cohort study of 159 cases. Gynecol Obstet Fertil. 2016;44:385\u201390.","journal-title":"Gynecol Obstet Fertil"},{"key":"4108_CR20","doi-asserted-by":"publisher","unstructured":"Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A (2017) Continuous support for women during childbirth. Cochrane Database Syst Rev 2017, Issue 7. Art. No.: CD003766. \nhttps:\/\/doi.org\/10.1002\/14651858.CD003766.pub6\n\n.","DOI":"10.1002\/14651858.CD003766.pub6"},{"key":"4108_CR21","unstructured":"Women\u2019s Healthcare Australasia. Why focus on preventing third and fourth degree tears? \nhttps:\/\/women.wcha.asn.au\/collaborative\/why-focus-preventing-third-and-fourth-degree-tears\n\n Accessed January 10, 2019."},{"issue":"2","key":"4108_CR22","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.wombi.2015.10.001","volume":"29","author":"M Porter","year":"2016","unstructured":"Porter M, Todd AL, Zhang LY. Ethnicity or cultural group identity of pregnant women in Sydney, Australia: is country of birth a reliable proxy measure? Women Birth. 2016;29(2):168\u201371.","journal-title":"Women Birth"},{"issue":"6","key":"4108_CR23","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s00192-011-1609-7","volume":"23","author":"AM Roos","year":"2012","unstructured":"Roos AM, Abdool Z, Thakar R, Sultan A. Predicting anal sphincter defects: the value of clinical examination and manometry. Int Urogynecol J. 2012;23(6):775\u201363.","journal-title":"Int Urogynecol J"},{"key":"4108_CR24","unstructured":"Royal College of Obstetricians and Gynaecologists. (2015) The management of third- and fourth-degree perineal tears Green-top Guideline No. 29 \nhttps:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/gtg-29.pdf\n\n Accessed 24 Nov 2016."},{"key":"4108_CR25","doi-asserted-by":"publisher","first-page":"e001649","DOI":"10.1136\/bmjopen-2012-001649","volume":"2","author":"K Laine","year":"2012","unstructured":"Laine K, Skjeldestad FE, Sandvik L, Staff AC. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study. BMJ Open [cited 2017 Nov 26]. 2012;2:e001649. \nhttps:\/\/doi.org\/10.1136\/bmjopen-2012-001649\n\n.","journal-title":"BMJ Open"},{"issue":"3","key":"4108_CR26","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s00192-016-3176-4","volume":"28","author":"M Naidu","year":"2017","unstructured":"Naidu M, Sultan AH, Thakar R. Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience. Int Urogynecol J. 2017;28(3):381\u20139.","journal-title":"Int Urogynecol J"},{"key":"4108_CR27","unstructured":"Royal College of Obstetricians and Gynaecologists (2017) The OASI Care Bundle Project \nhttps:\/\/www.rcog.org.uk\/OASICareBundle\n\n Accessed 28 Nov 2017."},{"issue":"26","key":"4108_CR28","doi-asserted-by":"publisher","first-page":"1905","DOI":"10.1056\/NEJM199312233292601","volume":"329","author":"AH Sultan","year":"1993","unstructured":"Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI. Anal- sphincter disruption during vaginal delivery. N Engl J Med. 1993;329(26):1905\u201311.","journal-title":"N Engl J Med"},{"issue":"1","key":"4108_CR29","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/ajo.12038","volume":"53","author":"AJ Ampt","year":"2013","unstructured":"Ampt AJ, Ford JB, Roberts CL, Morris JM. Trends in obstetric anal sphincter injuries and associated risk factors for vaginal singleton term births in New South Wales 2001\u20132009. Aust N Z J Obstet Gynaecol. 2013;53(1):9\u201316.","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"12","key":"4108_CR30","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1111\/1471-0528.12363","volume":"120","author":"I Gurol-Urganci","year":"2013","unstructured":"Gurol-Urganci I, Cromwell DA, Edozien LC, et al. Third- and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors. BJOG. 2013;120(12):1516\u201325.","journal-title":"BJOG"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-019-04108-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00192-019-04108-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-019-04108-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T19:18:31Z","timestamp":1600111111000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00192-019-04108-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,16]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["4108"],"URL":"https:\/\/doi.org\/10.1007\/s00192-019-04108-3","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,16]]},"assertion":[{"value":"17 April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"None.This study has been approved by the South-Eastern Sydney Local Health District Human Research Ethics Committee [HREC 14\/165]. The Research Support Office can be contacted on SESLHD_RSO@health.nsw.gov.au","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"1. Urogynaecology Society of Australasia Melbourne, Australia. 31 March 2017.2. Australian Physiotherapy Association National Conference. Sydney Australia. 16 October 2017.3. Continence Foundation of Australia, National Conference. Sydney, Australia. 17 November 2017","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conference presentations"}}]}}