Reviewer ’s report  
 
Title: Anal incontinence and unrecognized anal sphincter injuries after vaginal delivery - A 
cross -sectional  study in Norway  
 
Version: 0 Date: 17 Dec 2019  
 
Reviewer: Zeelha Abdool  
 
Reviewer's report:  
 
Hi 
 
I have the ffg questions:  
 
1. Pg 1 L18 - please clarify if these were primiparous women  
 
2. Pg 2 L50 - It will be valuable  if you add sentence for the reason of the decrease in the 
prevalence of OASIS in Norway.  
 
3. Pg 3 L71 - Corton et al is inappropriately cited in the middle of your methodology. I suggest 
you move the findings by Corton et al to the background  
 
4. Pg 5 L12 1- in results please add the median time clinical examination and ultrasound for 
completeness  
 
5. Pg 7 L157 - Table 2 shows a St Marks score of 4.7, but you have 4.6 in the text. Explain  
 
6. The authors have studied the height of the anal sphincter complex but fail to define its 
boundaries. Addition of a figure of the height of the anal sphincter of figure 1 is recommended.  
 
7. Pg 8 L181 - Clinical examination and endoanal ultrasound were pe rformed at least 4 months 
postpartum, but table 1 has a median of 15 months. Please clarify  
 
8. Pg 8 L191 - Your finding of 9.3% is lower than 14 and 40% - yet you state similar? Explain or 
amend  
 
9. Pg 8 L 197 - 199- You state that your findings imply that i t will not be possible to detect all 
OASIS by means of rectal exploration and visual inspection...But yet you have shown that the 
perineal body is statistically significantly shorter in those who sustained an injury. Explain the 
discrepancy  
 
10. Pg 10 L 23 5- cesarean and not cesarian - please correct the spelling  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify whi ch controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you  recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please in dicate the quality of language in the manuscript:  
 
Acceptable  
 
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