Conclusion
OASIs are still being missed by accouchers, and midwives failed to identify 80% of OASIS. TPUS identified 91% of OASIs compared to 71% detected by the accoucher suggesting that the detection rate with TPUS may be better. However, TPUS requires specialist skills to perform and interpret the images immediately after delivery and does not detect all OASIS and therefore cannot be a substitute for training in clinical diagnosis. More robust methods of education and assessment of competency therefore need to be implemented for midwives and doctors to improve the identification of OASIs.