Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

Abstract

Background/Aim. To evaluate the obstetrics and gynaecology residents' perspective of their training and experience in the management of perineal tears that occur during assisted vaginal delivery. We hypothesised that residents would perceive room for improvement in their knowledge of pelvic floor anatomy and the training received in tears repair. Design. Descriptive cross-sectional study. Population/Setting. Seventy-two major residents from all teaching hospitals in Catalonia. Methods. A questionnaire was designed to evaluate experience, perception of the training and supervision provided. Results. The questionnaire was sent to all residents (n = 72), receiving 46 responses (64%). The participants represented 15 out of the 16 teaching hospitals included in the study (94% of the hospitals represented). Approximately, 52% of residents were in their third year while 48% were in their fourth. The majority of them thought that their knowledge of pelvic floor anatomy was poor (62%), although 98% felt confident that they would know when an episiotomy was correctly indicated. The survey found that they lacked experience in the repair of major degree tears (70% had repaired fewer than ten), and most did not carry out followup procedures. Conclusion. The majority of them indicated that more training in this specific area is necessary (98%).

Professional’s skills in assessment of perineal tears after childbirth—A systematic review

“…Six studies on the topic of healthcare professionals' knowledge in assessing and classifying perineal tears ( Table 1) were identified [22,[26][27][28][29][30], see description of included studies in Table 2. In all studies data were collected through questionnaires.…”

“…Both studies indicate poor knowledge in perineal anatomy. Cornet et al [27] investigated residents' own perception of knowledge in perineal anatomy. A majority (62%) of the residents thought their knowledge in pelvic floor anatomy was inadequate.…”

Are Obstetrics and Gynecology Residents Proficient in the Repair of Third and Fourth Degree Perineal Tears?An Anonymous Survey in a Teaching Hospital in North Central Nigeria

“…[8] The devastating consequences of obstetric sphincteric injuries demand that when they do occur, resident doctors in obstetrics and Gynaecology should be able to call on the resources of specialists who themselves have been tutored specifically in detecting and carrying out such repairs. Perineal examination by an experienced person is said to double the rate of anal sphincter injury.…”

“…[7,8] This is against a background of generally poor exposure of obstetrics and gynaecology residents to vaginal procedures. [9] This research aims to evaluate the experience of and training of residents in obstetrics and Gynaecology in the identification and repair of third and fourth degree perineal tears that occur during vaginal delivery.…”

Comparison of 2 Simulation Models for Teaching Obstetric Anal Sphincter Repair

“…7,8 Formal residency training in OAS repair has been inconsistent, with 60% of obstetrics and gynecology residents in the United States admitting no didactic teaching on episiotomy repair and reporting direct supervision only one third of the time. 7,8 Formal residency training in OAS repair has been inconsistent, with 60% of obstetrics and gynecology residents in the United States admitting no didactic teaching on episiotomy repair and reporting direct supervision only one third of the time.…”