[Obstetrical anal sphincter injury : How to manage the subsequent delivery ?]

Obstetric anal sphincter injury (OASI) is a complication of vaginal delivery. Its potential consequences are numerous and include anal and/or fecal incontinence, sexual problems and perineal pain, which can be aggravated by future pregnancies and childbirth. One common issue after OASI is the assessment of anorectal function to discuss the delivery modalities during the next pregnancy. This dedicated assessment includes a clinical and paraclinical evaluation, with an ultrasound and/or a manometry. This personalized assessment for each patient with a history of sphincter injury allows for a detailed discussion to decide on the route of delivery in an informed manner.