Anushae Akhtar
Kings College London , UKPresentation Title:
Risk factors, management, and follow-up of obstetric anal sphincter injuries: An audit from a UK district general hospital
Abstract
Background: Obstetric anal sphincter injuries (OASIs) are a major cause of maternal morbidity. This audit evaluated risk factors, intrapartum management, postoperative care, and follow-up of OASI cases at a UK district general hospital, benchmarking practices against national guidance.
Methodology: A retrospective audit was conducted for women who sustained OASI between January 1 and December 31, 2023. Data were extracted from electronic and paper records. Outcomes were assessed against the Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline No. 29 standards. The prevalence of OASI among total and vaginal deliveries in 2023 was reported.
Results: Twenty-eight women sustained OASI; 23 (82%) were primiparous, and 10 (36%) had an instrumental delivery. Episiotomy was performed in 14 (50%). Perineal support was recorded in 19 (68%). Postoperative care aligned well with standards: antibiotics in 26 cases (93%), physiotherapy referral in 27 (96%), and laxatives in 22 (79%). Gynaecology follow-up referral was documented in 21 (75%) cases. OASI prevalence in 2023 was 13.3% of all births and 22.8% of vaginal births at our unit.
Conclusions: Primiparity and instrumental delivery were common risk factors. Immediate postoperative care met most standards, but documentation and follow-up referrals were inconsistent. A structured OASI proforma and standardized referral pathway are recommended to improve continuity of care. Recognition of high-risk women and consistent use of preventive strategies, together with structured counselling for future deliveries, may further improve outcomes.
Biography
Anushae Akhtar is a F3 doctor currently working in the United Kingdom. She completed her Foundation Year 1 and Foundation Year 2 training at George Eliot Hospital and University Hospital Coventry and Warwickshire. During her foundation training, she completed six rotations across Obstetrics and Gynaecology, Acute Medicine, General Surgery, Respiratory Medicine, General Practice, and Neurology. These placements have provided her with a broad clinical foundation and strengthened her skills in multidisciplinary teamwork, patient communication, and evidence-based decision-making. Through her experiences in Obstetrics and Gynaecology, she developed a particular interest in maternal health and quality improvement, which led to her involvement in this audit on obstetric anal sphincter injuries (OASIs). She is currently pursuing a Master’s degree in Clinical Dermatology at Kings College London -- reflecting her commitment to continuous learning and broadening her clinical expertise. Her professional interests include women’s health, dermatology, and healthcare improvement through research and audit. She aims to continue contributing to patient safety and clinical excellence across a range of medical specialties.
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