Postpartum Perineal Assessment After Vaginal Birth and Detection of Obstetric Anal Sphincter Injury: A Scoping Review
ABSTRACT Background Obstetric anal sphincter injuries (OASIs) are often under‐recognised. International guidelines vary, especially on postpartum reassessment and diagnostic escalation. Search Strategy, Data Collection and Analysis A PRISMA‐ScR scoping review mapped international guidance and supporting evidence, with AGREE II appraisal of formal guideline sets. Main Results We included 14 core guidelines, 3 regional documents and 31 evidence sources. Guidelines addressed immediate postpartum perineal assessment, but recommendations varied considerably regarding digital rectal examination, role and timing of imaging, diagnostic escalation and structured follow‐up. Guidance on implementation, including documentation, training and audit/quality improvement, was also inconsistent across documents. Conclusions These key gaps highlight areas for future research and guideline development.
Authors
- Jan Filip Baekelandt (ORCID: https://orcid.org/0000-0002-8344-8622)
- Ruwan Fernando (ORCID: https://orcid.org/0000-0003-4373-8403)
- Stephan Kropshofer
- Antonino Spinelli (ORCID: https://orcid.org/0000-0002-1493-1768)
- Hynek Heřman (ORCID: https://orcid.org/0000-0001-5732-3159)
- Stavros Athanasiou (ORCID: https://orcid.org/0000-0003-0005-0369)
- Renaud de Tayrac (ORCID: https://orcid.org/0000-0002-4352-4782)
- Adam Janusz Dziki (ORCID: https://orcid.org/0000-0002-5439-6237)
- Diaa E. E. Rizk (ORCID: https://orcid.org/0000-0002-9414-7059)
- Abdul H. Sultan (ORCID: https://orcid.org/0000-0001-8979-2304)
- Carlo Ratto (ORCID: https://orcid.org/0000-0002-0556-0037)
- Magdalena Emilia Grzybowska (ORCID: https://orcid.org/0000-0002-5311-3450)
- Mariusz Grzesiak (ORCID: https://orcid.org/0000-0002-6900-4347)
- Andrea Stuart (ORCID: https://orcid.org/0000-0002-5131-6297)
- Stefano Salvatore (ORCID: https://orcid.org/0000-0002-4098-1590)
- Peter L. Rosenblatt
Institutions
- Università Cattolica del Sacro Cuore (IT)
- Mount Auburn Hospital (US)
- Humanitas University (IT)
- Harvard University (US)
- Innsbruck Medical University (AT)
- Imperial College Healthcare NHS Trust (GB)
- Vita-Salute San Raffaele University (IT)
- Lund University (SE)
- Universität Innsbruck (AT)
- Université de Montpellier (FR)
- National and Kapodistrian University of Athens (GR)
- Charles University (CZ)
- Croydon University Hospital (GB)
- Centre Hospitalier Universitaire de Nîmes (FR)
- St Mary's Hospital (GB)
- Medical University of Lodz (PL)
- IRCCS Ospedale San Raffaele (IT)
- Imelda Hospital (BE)
- Skåne University Hospital (SE)
- Ústav pro Péči o Matku a Dítě (CZ)
- Polish Mother’s Memorial Hospital Research Institute (PL)
- IRCCS Humanitas Research Hospital (IT)
- Imperial College London (GB)
- Arabian Gulf University (BH)
- Brunel University of London (GB)
- Gdańsk Medical University (PL)
Publication Details
- Journal
- BJOG An International Journal of Obstetrics & Gynaecology
- Published
- 2026-11-08
- DOI
- https://doi.org/10.1111/1471-0528.70365
- Primary Topic
- Pelvic floor disorders treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00