Study suggests that initiation of the OASI Care Bundle will reduce the risk of severe tearing in childbirth

Posted: 27/11/2020

A recent study published in BJOG: An International Journal of Obstetrics and Gynaecology has shown promising potential for reducing instances of perineal trauma during childbirth. The OASI Care Bundle seeks to use preventative measures in order to reduce the likelihood of injury. These measures include the distribution of antenatal information to women, manual perineal protection and mediolateral episiotomy when indicated.

An obstetric anal sphincter injury (OASI) is graded as a third‐ or fourth‐degree perineal tear, and is affecting an increasing number of women during childbirth. The NHS reported that OASI rates tripled among first time mothers over the decade beginning in 2000, from 1.8% to 5.9% in 2011. The NHS stated that this increase can be linked to improved recognition of tears, changes in practice and gaps in training. Long‐term outcomes of OASI can be severe and can include chronic pain, sexual dysfunction and urinary or anal incontinence.

Clinicians involved in the study developed the OASI Care Bundle, which demonstrates three components: informing women of the risks of OASI, documenting the use of manual penineal protection and a requirement that the perineum be checked carefully following birth in order to improve detection of perineal injuries and instigate prompt repair.

The study, which took place between October 2016 and March 2018 across 16 maternity units nationally, found that the OASI rate amongst study participants decreased from 3.3% before to 3.0% after the Care Bundle was implemented, with no significant changes in caesarean section or episiotomy rates.

Emily Reville, senior associate at Penningtons Manches Cooper, commented: “Unfortunately, we see many cases where women have suffered OASI injuries which can be devastating both physically and emotionally. We welcome any changes or initiatives which will hopefully help reduce the number of such injuries in the future.”

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