Detection of obstetric anal sphincter injuries: From the fear
of malpractice to a quality indicator of a center

J 2026

Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center

FERNANDO, Ruwan; Ewa BARCZ; Antonino SPINELLI; de Tayrac RENAUD; Carlo RATTO et al.

Základní údaje

Originální název

Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center

Autoři

Vydání

INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, Hoboken, Wiley, 2026, 0020-7292

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.400 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

healthcare transparency; maternal healthcare; OASI; obstetric care quality; vaginal delivery

Štítky

14110240, 14110611, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 2. 3. 2026 14:34, Mgr. Tereza Miškechová

Anotace

V originále

Obstetric anal sphincter injuries (OASIs) constitute a significant complication in vaginal childbirth, affecting up to 26% of deliveries and representing the leading cause of anal incontinence among women. Despite their prevalence and serious long-term consequences, OASIs remain widely underreported, partly because of clinicians' hesitancy linked to fear of litigation, peer criticism, and a pervasive culture that discourages disclosure of adverse events. Recent evidence emphasizes that underreporting exacerbates rather than mitigates legal risks and patient harm, underscoring the urgent need for systemic changes. This article reviews critical factors contributing to OASI underreporting, including inadequate clinical training, inconsistent national guidelines, variable litigation landscapes, and differing diagnostic practices across European healthcare systems. Examples from the UK, Poland, Sweden, Norway, France, Italy, the Czech Republic, and Belgium demonstrate significant variations in prevention strategies, diagnostic accuracy, and management protocols, reflecting uneven progress and highlighting opportunities for standardized care improvements. These national discrepancies in OASI definitions, classification, and reporting thresholds may lead to significant inconsistencies in both clinical outcomes and statistical comparisons across healthcare systems. Implementing structured training, standardized protocols, multidisciplinary collaboration, and transparent reporting systems are essential for improving maternal outcomes and reducing litigation risks. Encouraging an institutional culture of accountability and openness will support continuous improvement, ensuring enhanced patient safety and quality care across global healthcare systems.

Citovat

FERNANDO, Ruwan; Ewa BARCZ; Antonino SPINELLI; de Tayrac RENAUD; Carlo RATTO; Stavros ATHANASIOU; Diaa Essameldin Ali RIZK; Andrea STUART; Jan BAEKELANDT; Hynek HERMAN; Petr JANKŮ; Peter ROSENBLAT; Adam DZIKI; Mariusz GRZESIAK; Przemyslaw OSZUKOWSKI; Katarzyna BORYCKA a Stefano SALVATORE. Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center. INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS. Hoboken: Wiley, 2026, roč. 172, č. 2, s. 710-716. ISSN 0020-7292. Dostupné z: https://doi.org/10.1002/ijgo.70415.

@article{2557847,
   author = {Fernando, Ruwan and Barcz, Ewa and Spinelli, Antonino and Renaud, de Tayrac and Ratto, Carlo and Athanasiou, Stavros and Rizk, Diaa Essameldin Ali and Stuart, Andrea and Baekelandt, Jan and Herman, Hynek and Janků, Petr and Rosenblat, Peter and Dziki, Adam and Grzesiak, Mariusz and Oszukowski, Przemyslaw and Borycka, Katarzyna and Salvatore, Stefano},
   article_location = {Hoboken},
   article_number = {2},
   doi = {https://doi.org/10.1002/ijgo.70415},
   keywords = {healthcare transparency; maternal healthcare; OASI; obstetric care quality; vaginal delivery},
   language = {eng},
   issn = {0020-7292},
   journal = {INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS},
   title = {Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center},
   url = {https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70415},
   volume = {172},
   year = {2026}
}

TY  - JOUR
ID  - 2557847
AU  - Fernando, Ruwan - Barcz, Ewa - Spinelli, Antonino - Renaud, de Tayrac - Ratto, Carlo - Athanasiou, Stavros - Rizk, Diaa Essameldin Ali - Stuart, Andrea - Baekelandt, Jan - Herman, Hynek - Janků, Petr - Rosenblat, Peter - Dziki, Adam - Grzesiak, Mariusz - Oszukowski, Przemyslaw - Borycka, Katarzyna - Salvatore, Stefano
PY  - 2026
TI  - Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center
JF  - INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
VL  - 172
IS  - 2
SP  - 710-716
EP  - 710-716
PB  - Wiley
SN  - 00207292
KW  - healthcare transparency
KW  - maternal healthcare
KW  - OASI
KW  - obstetric care quality
KW  - vaginal delivery
UR  - https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70415
N2  - Obstetric anal sphincter injuries (OASIs) constitute a significant complication in vaginal childbirth, affecting up to 26% of deliveries and representing the leading cause of anal incontinence among women. Despite their prevalence and serious long-term consequences, OASIs remain widely underreported, partly because of clinicians' hesitancy linked to fear of litigation, peer criticism, and a pervasive culture that discourages disclosure of adverse events. Recent evidence emphasizes that underreporting exacerbates rather than mitigates legal risks and patient harm, underscoring the urgent need for systemic changes. This article reviews critical factors contributing to OASI underreporting, including inadequate clinical training, inconsistent national guidelines, variable litigation landscapes, and differing diagnostic practices across European healthcare systems. Examples from the UK, Poland, Sweden, Norway, France, Italy, the Czech Republic, and Belgium demonstrate significant variations in prevention strategies, diagnostic accuracy, and management protocols, reflecting uneven progress and highlighting opportunities for standardized care improvements. These national discrepancies in OASI definitions, classification, and reporting thresholds may lead to significant inconsistencies in both clinical outcomes and statistical comparisons across healthcare systems. Implementing structured training, standardized protocols, multidisciplinary collaboration, and transparent reporting systems are essential for improving maternal outcomes and reducing litigation risks. Encouraging an institutional culture of accountability and openness will support continuous improvement, ensuring enhanced patient safety and quality care across global healthcare systems.
ER  -

FERNANDO, Ruwan; Ewa BARCZ; Antonino SPINELLI; de Tayrac RENAUD; Carlo RATTO; Stavros ATHANASIOU; Diaa Essameldin Ali RIZK; Andrea STUART; Jan BAEKELANDT; Hynek HERMAN; Petr JANKŮ; Peter ROSENBLAT; Adam DZIKI; Mariusz GRZESIAK; Przemyslaw OSZUKOWSKI; Katarzyna BORYCKA a Stefano SALVATORE. Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center. \textit{INTERNATIONAL JOURNAL OF GYNECOLOGY \&{} OBSTETRICS}. Hoboken: Wiley, 2026, roč.~172, č.~2, s.~710-716. ISSN~0020-7292. Dostupné z: https://doi.org/10.1002/ijgo.70415.

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