“Obstetric anal sphincter injury: 7 critical questions about care,” by Ranee Thakar, MD, MRCOG, and Abdul H. Sultan, MD, FRCOG (February)
Figure 9 on page 65 of the February issue should have reflected the uncertainty of cesarean section as a management option in symptomatic women with a severe injury and in asymptomatic women with a borderline injury; in some cases, vaginal delivery may be a better option. In addition, the definitions in the legend were incorrect.
The corrected algorithm and legend appear below and in the article archives at www.obgmanagement.com.
FIGURE 9 How do you determine the mode of delivery after OASIS?
Intact=no external anal sphincter defect and normal pressures
Borderline=external anal sphincter defect >1 hr and <2 hr (1 hr=30°) and anal pressure increment of 20–40 mm Hg
Severe=external anal sphincter defect >2 hr and anal pressure increment below 20 mm Hg