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Chapter 6 - Obstetric Perineal Trauma

Published online by Cambridge University Press:  22 April 2022

By
Abdul H Sultan
Edited by
Swati Jha  and
Eloise Power
Swati Jha
Affiliation:
Royal Hallamshire Hospital, Sheffield
Eloise Power
Affiliation:
Sergeants’ Inn, London
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Summary

The claimant, an equity sales trader in the City of London, during the birth of her first child suffered an obstetric anal sphincter injury whilst in private obstetric care. This went undetected, leaving her with significant ongoing symptoms which caused embarrassment, inconvenience and distress, resulting in an impact on her career trajectory. It was claimed that the defendant performed a midline episiotomy which caused a third-degree tear affecting both her internal and external anal sphincter.

Type
Chapter
Information
Lessons from Medicolegal Cases in Obstetrics and Gynaecology
Improving Clinical Practice
 , pp. 69 - 82
Publisher: Cambridge University Press
Print publication year: 2022

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References

Sultan, AH. Obstetric perineal injury and anal incontinence. Clin Risk 1999; 5: 193–6.CrossRefGoogle Scholar
Royal College of Obstetricians and Gynaecologists. RCOG Green-top Guideline No. 29. Management of Third- and Fourth-degree Perineal Tears Following Vaginal Delivery. London: RCOG Press; 2015.Google Scholar
Roper, JC, Thakar, R, Sultan, AH. Isolated rectal buttonhole tears in obstetrics: case series and review of the literature. Int Urogynecol J 2021; 32(3): 745.Google Scholar
Sultan, AH, Thakar, R, Fenner, D. Perineal and Anal Sphincter Trauma. London: Springer; 2007, 13–32.CrossRefGoogle Scholar
National Institute of Health and Care Excellence. Intrapartum Care [CG190]. London: NICE; 2014. Available at: www.nice.org.uk/guidance/cg190Google Scholar
www.perineum.netGoogle Scholar
Murphy, DJ, Strachan, BK, Bahl, R, on behalf of the Royal College of Obstetricians Gynaecologists. Assisted Vaginal Birth. BJOG 2020. https://doi.org/10.1111/1471-0528.16092Google Scholar
Sultan, AH, Kamm, MA, Hudson, CN, Thomas, JM, Bartram, CI. Anal sphincter disruption during vaginal delivery. New Engl J Med 1993; 329: 1905–11.CrossRefGoogle ScholarPubMed
Andrews, V, Thakar, R, Sultan, AH, Jones, PW. Occult anal sphincter injuries – myth or reality? BJOG 2006; 113: 195–200.CrossRefGoogle ScholarPubMed
Sioutis, D, Thakar, R, Sultan, AH. Overdiagnosis and rising rate of obstetric anal sphincter injuries (OASIS): time for reappraisal. Ultrasound Obstet Gynecol 2017; 50(5): 642–7.CrossRefGoogle ScholarPubMed
Andrews, V, Thakar, R, Sultan, AH. Outcome of an obstetric anal sphincter injury can be optimised by structured training and using an evidence-based protocol. Int Urogynecol J 2009; 20(2): 973–8.Google Scholar
Royal College of Obstetricians and Gynaecologists. A Third- or Fourth-degree Tear during Birth: Information for You. London: RCOG; 2015.Google Scholar
Wan, OYK, Taithongchai, A, Veiga, SI, Sultan, AH, Thakar, R. A one-stop perineal clinic: our eleven-year experience. Int Urogynecol J 2020; 31(11): 2317–26.Google Scholar
Abramowitz, L, Mandelbrot, L, Bourgeois Moine, A, Tohic, AL, Carne Carnavalet, C, Poujade, O, Roy, C, Tubach, F. Caesarean section in the second delivery to prevent anal incontinence after asymptomatic obstetric anal sphincter injury: the EPIC multicentre randomised trial. BJOG 2020. https://doi.org/10.1111/1471–0528.16452CrossRefGoogle Scholar
Okeahialam, NA, Wong, KW, Roper, J, Thakar, R, Sultan, AH. Cesarean section in the second delivery to prevent anal incontinence after asymptomatic obstetrical anal sphincter injury: the EPIC multicentre randomised trial. BJOG 2021; 128(4): 770–1.CrossRefGoogle ScholarPubMed
D’Souza, JC, Monga, A, Tincello, DG, Sultan, AH, Thakar, R, Hillard, TC, Grigsby, S, Kibria, A, Jordan, CF, Ashmore, C. Maternal outcomes in subsequent delivery after previous obstetric anal sphincter injury (OASI): a multi-centre retrospective cohort study. Int Urogynecol J 2020; 31(3): 627–33.Google Scholar
Jordan, PA, Naidu, M, Thakar, R, Sultan, AH. Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury. Int Urogynecol J 2018; 29(11): 1579–88.Google Scholar
Taithongchai, A, Thakar, R, Sultan, AH. Management of subsequent pregnancies following fourth-degree obstetric anal sphincter injuries (OASIS). Eur J Obstet Gynecol Reprod Biol 2020; 250: 80–5.Google Scholar
Jha, S, Parker, V. Risk factors for recurrent obstetric anal sphincter injury (rOASI): a systematic review and meta-analysis. Int Urogynecol J 2016; 27(6): 849–57.CrossRefGoogle ScholarPubMed
Sultan, AH, Ritchie, A, Mooney, G. Obstetric anal sphincter injuries: review of recent medico-legal aspects. Clin Risk 2016; 22(3–4): 57–60. https://doi.org/10.1177/1356262216676131.Google Scholar

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