Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study
| Autor: | Sahar Hassan, Mohammed Zimmo, Bettina Böttcher, Manuela Zucknick, Erik Fosse, Hadil Ali-Masri, Kaled Zimmo, Åse Vikanes, Katariina Laine |
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| Rok vydání: | 2019 |
| Předmět: |
Episiotomy
Adult medicine.medical_specialty Animated instructions video Palestine Urology medicine.medical_treatment Psychological intervention Episiotomy rates Midwifery Perineum Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Intervention (counseling) medicine Humans 030212 general & internal medicine Prospective Studies Bimanual perineal support technique 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Odds ratio Intervention studies Confidence interval Computers Handheld Physical therapy Female Original Article business Hands-on Cohort study Computer-Assisted Instruction |
| Zdroj: | International Urogynecology Journal |
| ISSN: | 0937-3462 |
| Popis: | Introduction and hypothesis In Palestine, episiotomy is frequently used among primiparous women.This study assesses the effect of training birth attendants in applying bimanual perineal support during delivery by either animated instruction on tablets or hands-on training on episiotomy rates among primiparous women. Methods An interventional cohort study was performed from 15 October 2015 to 31 January 2017, including all primiparous women with singletons and noninstrumental vaginal deliveries at six Palestinian hospitals. Intervention 1 (animated instructions on tablets) was conducted in Hospitals 1, 2, 3, and 4. Intervention 2 (bedside hands-on training) was applied in Hospitals 1 and 2 only. Hospitals 5 and 6 did not receive interventions. Differences in episiotomy rates in intervention and nonintervention hospitals were assessed before and after the interventions and presented as p values using chi-square test, and odds ratios (OR) with 95% confidence intervals (CI). Differences in the demographic and obstetric characteristics were presented as p values using the Kruskal–Wallis test. Results Of 46,709 women, 12,841 were included. The overall episiotomy rate in the intervention hospitals did not change significantly after intervention 1, from 63.1 to 62.1% (OR = 0.96, 95% CI 0.84–1.08), but did so after intervention 2, from 61.1 to 38.1% (OR = 0.39, 95% CI 0.33–0.47). Rates after Intervention 2 changed from 65.0 to 47.3% (OR = 0.52, 95% CI 0.40–0.67) in Hospital 1 and from 39.4 to 25.1% (OR = 0.49, 95% CI 0.35–0.68) in Hospital 2. Conclusions Hands-on training of bimanual perineal support during delivery of primiparous women was significantly more effective in reducing episiotomy rates than animated instruction videos alone. Electronic supplementary material The online version of this article (10.1007/s00192-018-3711-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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