TY - JOUR
T1 - Structured hands-on workshop decreases the over-detection rate of obstetrical anal sphincter injuries
AU - Krissi, Haim
AU - Aviram, Amir
AU - Hiersch, Liran
AU - Ashwal, Eran
AU - Eitan, Ram
AU - Peled, Yoav
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Purpose: The purpose of this study was to assess the effect of a structured hands-on workshop on the detection rate of obstetric anal sphincter injuries. Methods: All physicians attending the delivery ward in our institution participated in a structured obstetric anal sphincter injury hands-on workshop developed by Dr. Ranee Thakar and Dr. Abdul Sultan which demonstrated proper identification and techniques for obstetric anal sphincter injury detection and repair. We retrospectively reviewed the electronic records of all singleton-pregnancy women who delivered vaginally (vertex presentation) during the 2 years prior to and 1 year following the workshop to assess the workshop’s effect on the rate of detection of obstetric anal sphincter injuries. Results: Overall, 20,484 women met the inclusion criteria during the study period and were eligible for final analysis. There were no significant differences in patient’s characteristics between the groups. Women in the pre-workshop group had a higher rate of obstetric anal sphincter injuries than the post-workshop group (0.4 vs. 0.2 %, p = 0.005). On multivariate analysis, factors independently associated with a decreased risk for obstetric anal sphincter injuries were deliveries in the post-workshop period (odds ratio 0.43, 95 % confidence interval 0.24–0.79, p = 0.006), parity (odds ratio 0.37, 95 % confidence interval 0.25–0.54, p < 0.001), and spontaneous vaginal delivery (odds ratio 0.43, 95 % confidence interval 0.26–0.71, p = 0.001). Conclusions: A proper detection of obstetric anal sphincter injuries may depend on the experience of the assessor. A structured hands-on workshop is important to avoid over diagnosis third-degree perineal tears.
AB - Purpose: The purpose of this study was to assess the effect of a structured hands-on workshop on the detection rate of obstetric anal sphincter injuries. Methods: All physicians attending the delivery ward in our institution participated in a structured obstetric anal sphincter injury hands-on workshop developed by Dr. Ranee Thakar and Dr. Abdul Sultan which demonstrated proper identification and techniques for obstetric anal sphincter injury detection and repair. We retrospectively reviewed the electronic records of all singleton-pregnancy women who delivered vaginally (vertex presentation) during the 2 years prior to and 1 year following the workshop to assess the workshop’s effect on the rate of detection of obstetric anal sphincter injuries. Results: Overall, 20,484 women met the inclusion criteria during the study period and were eligible for final analysis. There were no significant differences in patient’s characteristics between the groups. Women in the pre-workshop group had a higher rate of obstetric anal sphincter injuries than the post-workshop group (0.4 vs. 0.2 %, p = 0.005). On multivariate analysis, factors independently associated with a decreased risk for obstetric anal sphincter injuries were deliveries in the post-workshop period (odds ratio 0.43, 95 % confidence interval 0.24–0.79, p = 0.006), parity (odds ratio 0.37, 95 % confidence interval 0.25–0.54, p < 0.001), and spontaneous vaginal delivery (odds ratio 0.43, 95 % confidence interval 0.26–0.71, p = 0.001). Conclusions: A proper detection of obstetric anal sphincter injuries may depend on the experience of the assessor. A structured hands-on workshop is important to avoid over diagnosis third-degree perineal tears.
KW - Anal sphincter
KW - Delivery
KW - Perineal tears
UR - http://www.scopus.com/inward/record.url?scp=84953369902&partnerID=8YFLogxK
U2 - 10.1007/s00384-015-2365-9
DO - 10.1007/s00384-015-2365-9
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C2 - 26293790
AN - SCOPUS:84953369902
SN - 0179-1958
VL - 31
SP - 45
EP - 50
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 1
ER -