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Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries
Author(s) -
Frost Jonathan,
Gundry Rowan,
Young Helen,
Naguib Adel
Publication year - 2016
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 - 10.1016/j.ijgo.2015.12.011
Subject(s) - medicine , anal sphincter , multidisciplinary approach , sphincter , reduction (mathematics) , fecal incontinence , obstetrics , physical therapy , surgery , social science , geometry , mathematics , sociology
Abstract Objective To determine whether the introduction of a multidisciplinary intrapartum perineal‐care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. Methods A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012–2013) a multidisciplinary training program was implemented was compared with the rate after (2013–2014) implementation using logistic regression analysis. Results The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493–0.899; P = 0.008). Conclusions The integration of intrapartum perineal‐care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries.