| Title |
Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience
|
|---|---|
| Published in |
International Urogynecology Journal & Pelvic Floor Dysfunction, October 2016
|
| DOI | 10.1007/s00192-016-3176-4 |
| Pubmed ID | |
| Authors |
Madhu Naidu, Abdul H. Sultan, Ranee Thakar |
| Abstract |
Obstetric anal sphincter injuries (OASIs) are associated with significant short-term and long-term morbidity. Over the past decade, there has been a steady rise in the rate of OASIs. There is therefore a compelling need to identify strategies to minimize OASIs. The objective of this study was to determine if perineal support at the time of vaginal delivery can reduce the incidence and severity of OASIs. All labour ward staff including midwives and doctors were invited to train in the technique of perineal support during vaginal delivery. Two experts from Norway conducted workshops with practical hands-on training on pelvic models. The midwives and doctors underwent further training with women in labour, and mandatory training was continued within the department. All midwives and doctors were instructed to support the perineum during both spontaneous and assisted vaginal delivery. From April 2011 to November 2014, 11,135 women underwent vaginal delivery. The OASI rate decreased from 4.7 % to 4.1 % (p = 0.11). There was a significant reduction (0.9 % to 0.3 %, p < 0.001) in 3c third-degree and fourth-degree tears (major OASIs). In a multivariate analysis, perineal support was associated with a significant reduction in the rates of OASIs (23 %; OR 0.77, 95 % CI 0.63 - 0.95, p = 0.01]) and major OASIs (71 %; OR 0.34, 95 % CI 0.17 - 0.69, p = 0.03). This interventional study showed that perineal support during vaginal delivery can reduce the risk of major OASIs. With sustained reinforcement of this intervention programme, we anticipate a further reduction in OASI rates. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 94 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 16 | 17% |
| Student > Master | 15 | 16% |
| Researcher | 9 | 10% |
| Student > Postgraduate | 7 | 7% |
| Student > Ph. D. Student | 5 | 5% |
| Other | 18 | 19% |
| Unknown | 24 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 34% |
| Nursing and Health Professions | 25 | 27% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Social Sciences | 2 | 2% |
| Agricultural and Biological Sciences | 1 | 1% |
| Other | 3 | 3% |
| Unknown | 29 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 May 2017.
All research outputs
#15,169,543
of 25,374,647 outputs
Outputs from International Urogynecology Journal & Pelvic Floor Dysfunction
#1,589
of 2,900 outputs
Outputs of similar age
#176,863
of 323,142 outputs
Outputs of similar age from International Urogynecology Journal & Pelvic Floor Dysfunction
#19
of 37 outputs
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