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Incidence of obstetric anal sphincter injuries after implementing the Triepi‐45 tool to improve episiotomy angle in instrumental deliveries
Author(s) -
GonzalezDíaz Enrique,
Fernández Fernández Camino,
Gonzalo Orden Jose Manuel,
Fernández Corona Alfonso
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13055
Subject(s) - medicine , episiotomy , incidence (geometry) , cohort , perineum , obstetrics , vaginal delivery , cohort study , odds ratio , anal sphincter , retrospective cohort study , prospective cohort study , gynecology , pregnancy , surgery , genetics , physics , optics , biology
Objective To assess the impact of Triepi‐45—a tool that enables an episiotomy angle of 45° to be marked on the perineum at rest—on the incidence of obstetric anal sphincter injuries ( OASIS ) during operative vaginal delivery ( OVD ). Method A retrospective–prospective cohort study was performed among successive women who underwent OVD at Complejo Asistencial Universitario de de León, Spain, between 2011 and 2013 (preintervention cohort, n=986) and between 2014 and 2016 (intervention cohort, n=986) after implementation of an interventional programme in 2013 to improve the episiotomy angle, including use of Triepi‐45, in OVD . Results The intervention cohort had a lower incidence of OASIS than the preintervention cohort (70/986 [7.1%] vs 93/986 [9.4%]), but the difference was not significant, owing to the low use of Triepi‐45 in the intervention cohort (n=375). However, the OASIS incidence was significantly lower in the Triepi‐45 cohort than in the preintervention cohort (18/375 [4.8%] vs 93/986 [9.4%]; odds ratio, 0.47; 95% confidence interval, 0.26–0.86). Conclusion Use of Triepi‐45 had a positive impact on reducing OASIS in OVD . It remains essential to raise obstetricians’ awareness of the importance of the episiotomy angle and to implement the systematic use of tools to reduce the incidence of OASIS .