Documenting Perineal and Obstetrical Anal Sphincter Injury Care at Childbirth: A Cross-Sectional Study.

Autor:	Gong M; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC. Electronic address: merry.gong@alumni.ubc.ca., Mann GK; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC., Koenig N; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC., Geoffrion R; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC.
Jazyk:	angličtina
Zdroj:	Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC [J Obstet Gynaecol Can] 2021 Oct; Vol. 43 (10), pp. 1164-1169. Date of Electronic Publication: 2021 Mar 06.
DOI:	10.1016/j.jogc.2021.02.120
Abstrakt:	Objective: This study evaluates whether maternity care providers document guideline-based recommendations for the prevention and care of obstetrical anal sphincter injuries (OASIS) for their labour and delivery patients. Methods: We performed a cross-sectional study, aiming for a convenience sample of 60 primiparous women, over 19 years of age, equally representative of patients who experienced severe (third- and fourth-degree) and minimal (intact or first-degree) tears during vaginal birth. Information on patient demographics, delivery details, and guideline-endorsed preventative and management measures were collected. Descriptive statistics were used when appropriate. Results: We enrolled a total of 73 women, 34 of whom had severe tears and 39 of whom had minimal tears. Preventative measures, including fetal head control and perineal support during delivery, were documented for 1 out of 73 patients. The use of perineal massage and warm compress to the perineum was not documented. A rectal exam after delivery was documented for 30% (22/73) of all patients and 62% (21/34) of patients with OASIS. Sixty-five percent (22/34) of patients with OASIS received intravenous antibiotics, 88% (30/34) received laxatives, and 100% received nonsteroidal anti-inflammatory drugs. Post-void residual was not documented for any patients. Patients recalled being informed about their OASIS in 68% (23/34) of cases and being referred to pelvic physiotherapy in 47% (16/34) of cases. Conclusion: In our study, perineal care practices during and after childbirth, as detailed in the national OASIS guideline, were incompletely documented. This may indicate partial guideline adherence or suboptimal medical record-keeping. (Copyright © 2021 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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