International Urogynecology Journal

, Volume 20, Issue 9, pp 1095–1101 | Cite as

Mode of delivery after previous obstetric anal sphincter injuries (OASIS)—a reappraisal?

  • Inka Scheer
  • Ranee Thakar
  • Abdul H. SultanEmail author
Original Article


Introduction and hypothesis

To prospectively evaluate anorectal symptoms, quality of life (QoL), sphincter integrity and function after subsequent childbirth following previous obstetric anal sphincter injuries (OASIS).


A validated Manchester Health Questionnaire, endoanal sonography and manometry were performed during the third trimester and 13 weeks postpartum. Women without objective compromise of anal function were recommended a vaginal delivery and the others a caesarean section.


Seventy-three consecutive women with previous OASIS were seen during a subsequent pregnancy of whom 59 were reviewed 13 weeks following delivery. Anal manometry findings did not change significantly following a subsequent vaginal delivery or caesarean section. Only one new defect (internal sphincter) occurred after a vaginal delivery. There was no significant change in symptoms or QoL. Three (6.8%) sustained repeat OASIS.


Women who have no antenatal evidence of objective compromise of anal sphincter function can be reassured that a vaginal delivery is not associated with any significant deterioration in function or QoL.


Anal sphincter repair Pregnancy Mode of delivery Third-degree tears Anal ultrasound Quality of life 



I. Scheer was funded by a grant from the Mayday Childbirth Trust.

Conflicts of interest



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Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  1. 1.UrogynaecologyMayday University HospitalCroydonUK

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