The 'OASI' (Obstetric Anal Sphincter Injury) Bundle approach, used in UK and Scandinavia to reduce 3rd and 4th degree perineal tears, includes which key component?

• A Warm perineal compresses and manual perineal protection during crowning ✓
• B Routine episiotomy in all instrumental deliveries
• C Liberal use of fundal pressure in second stage
• D Strict head-down position (McRoberts) during all deliveries

Explanation

The OASI care bundle (based on Nordic and UK Quality Improvement Collaboratives) includes: (1) perineal massage in late first/second stage, (2) warm perineal compresses applied during second stage, (3) manual perineal protection (hands-on guarding) at crowning to slow head delivery, and (4) lateral episiotomy when required. Implementation of this bundle has been associated with 50% reduction in OASI rates in Norwegian and UK audits.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.