Obstetric Anal Sphincter Injury: Risk Factors, Management, and Recommendations, Literature Review

Abstract

This review presents the convenient insights on the diagnosis of obstetrical anal sphincter injury by utilizing postpartum ultrasound imaging. There is developing confirmation that anal sphincter tears are much of the time ignored after labour and, in any event, when diagnosed, regularly not well fixed, with an unnecessary rate of remaining imperfections after reconstruction. Indeed, even after postpartum diagnosis and primary repair, 25% to 50% of patients will have persistent anal incontinence. As clinical diagnosis may likewise fail in the detection and classification of obstetrical anal sphincter injury, the utilization of imaging has been proposed to work on the discovery and treatment of these lacerations. Prominently, 3D endoanal ultrasound is respected the best quality level in the identification of obstetrical anal sphincter injury, and as of late, 4D transperineal ultrasound, typically reachable in obstetrical and gynecologic settings, has laid out to be great too. Aversion of forceps delivery whenever the situation allows, execution of a rectal assessment after vaginal delivery and before repair of any severe perineal tear, and providing sonographic follow-up at 10 to 12 weeks after vaginal delivery in high-risk women (maternal age of ≥35 years, vaginal birth after caesarean delivery, forceps, delayed second phase of labour, obvious obstetrical anal sphincter injury, shoulder dystocia, and macrosomia) may moreover help reduce morbidity emerging from anal sphincter tears.