Mode of Birth after Obstetric Anal Sphincter Injury

  • Research type

    Research Study

  • Full title

    What are the long-term effects of subsequent birth mode and irritable bowel syndrome on anal incontinence in women with Obstetric Anal Sphincter Injury?

  • IRAS ID

    326315

  • Contact name

    Emily Carter

  • Contact email

    emily.carter@manchester.ac.uk

  • Clinicaltrials.gov Identifier

    CRD42022372442, PROSPERO systematic review protocol registration

  • Duration of Study in the UK

    1 years, 10 months, 1 days

  • Research summary

    Third- and fourth- degree tears, otherwise known as Obstetric Anal Sphincter Injuries (OASI) are a common complication of childbirth occurring in 6% of first-time mums. They are the commonest cause of anal incontinence (AI) in young women. AI is the involuntary loss of solid or liquid stool, gas or urgency symptoms, and negatively impact women’s quality of life in the long-term in up to 50% women after OASI. 300 women/year at MFT and 35,000 women annually in the UK have an OASI after giving birth.

    Women who have more children after an OASI have higher degrees of AI. We don’t know whether having a Caesarean section for subsequent birth is protective against developing long-term AI rather than having a vaginal birth. Clinical guidelines rely on expert opinion rather than robust evidence.

    This study investigates whether a caesarean section after OASI is protective against long-term AI. It also investigates whether this is acceptable to women by determining factors influencing women’s preferences for mode of birth after OASI. Our study uses a questionnaire study and an interview/focus group study to address these questions
    For the questionnaire study, we will send an online questionnaire survey for all women who have had an OASI at Manchester Foundation Trust since 2006. They will be contacted by post, asked to scan a QR code which will link to a consent form and online bowel function questionnaire. This should take 10 minutes to complete.

    For the interview study, we will recruit women who are deciding how to have their next baby after OASI in St Mary’s Hospital and determine the factors influencing their mode of birth choice.

    We anticipate that this study will take 1-2 years to complete and that the study is completed by one contact episode with each woman either by a virtual questionnaire or interview.

  • REC name

    North East - Tyne & Wear South Research Ethics Committee

  • REC reference

    23/NE/0213

  • Date of REC Opinion

    15 Dec 2023

  • REC opinion

    Further Information Favourable Opinion