An Audit of Clinician Compliance with Best Practice Recommendations to Repair Severe Obstetric Anal Sphincter Injuries

Abstract

Despite attempts at improving therapeutic outcomes by creating tailored guidelines for repair of obstetric anal sphincter injuries, there is a serious barrier to success because 65% of senior clinicians were noncompliant.

The impact of a nationwide hands‐on workshop on the diagnostic rates and management of obstetrical anal sphincter Injuries in Israel

“…However, educational interventions alone are not enough to make a significant change in practice; compliance with best practice recommendations is an important key for success. Cawich et al [41] found that, despite attempts at improving therapeutic outcomes by creating tailored guidelines for repair of OASI, a serious barrier to success was the finding that 65% of senior clinicians were noncompliant with guidelines [41]. In the current study, we found the use of Table 2 The rate of third-or fourth-degree perineal tears according to medical centre in the pre-and post-workshop periods.…”

“…Cawich et al . [41] found that, despite attempts at improving therapeutic outcomes by creating tailored guidelines for repair of OASI, a serious barrier to success was the finding that 65% of senior clinicians were noncompliant with guidelines [41]. In the current study, we found the use of the RCOG recommended perineal trauma classification system increased among physicians.…”

Incidence and Audit of Treatment on Third and Fourth Grade Perineal Tear

“…The incidence of 3 rd and 4 th grade perineal tear in United Kingdom was 2.9% (between 0-8%); whereas, 6.1% happened in primiparous and 1.7% in multiparous women. 1,2 Meanwhile, the incidence of 3 rd and 4 th grade of perineal tear in Austria were 1.5% and 0.1%, respectively. 3 The incidence of anal sphincter tear in mediolateral episiotomy population was 1.7% (2.9% on primiparous women) and 12% (19% on primiparous women) in mediana episiotomy population.…”

“…3 The incidence of anal sphincter tear in mediolateral episiotomy population was 1.7% (2.9% on primiparous women) and 12% (19% on primiparous women) in mediana episiotomy population. 1,2 The 3 rd and 4 th grade perineal tear often induces morbidity for women so that it influences the quality of life. Serious complication on vaginal delivery caused by perineal tear consists of fecal incontinence, pelvic disorders, dyspareuni, chronic pain, and finally it inflicts to social and severe psychological problem.…”

“…Serious complication on vaginal delivery caused by perineal tear consists of fecal incontinence, pelvic disorders, dyspareuni, chronic pain, and finally it inflicts to social and severe psychological problem. 1,4,5 An audit in national referral hospital in Jamaika showed that women suffered from high morbidity (43%) and fecal incontinence (23%) after the anal sphincter repair surgery. 6 Based on high morbidity caused by perineal tear, several studies conducted an audit of appropriate treatment in 3 rd and 4 th grade perineal tear.…”