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Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study

Katariina Laine1, Finn Egil Skjeldestad, Leiv Sandvik

  • 1Department of Obstetrics, Oslo University Hospital, Ullevål, Oslo, Norway.

BMJ Open
|October 19, 2012
PubMed

Insights

A training program significantly reduced obstetric anal sphincter injuries (OASIS) by 50%. This improvement in perineal protection was effective across all women subgroups, indicating a successful intervention for reducing OASIS incidence.

Area of Science:

  • Obstetrics and Gynecology
  • Surgical Safety
  • Patient Outcomes

Background:

  • Obstetric anal sphincter injuries (OASIS) are a significant concern in childbirth.
  • Previous incidence rates of OASIS necessitated the development of targeted interventions.

Purpose of the Study:

  • To evaluate the impact of a perineal support training program on OASIS incidence.
  • To assess OASIS rates before and after the training intervention.
  • To analyze OASIS incidence in relation to maternal, obstetrical, and fetal risk factors.

Main Methods:

  • A population-based cohort study was conducted in a university hospital setting.
  • Two cohorts of delivering women were analyzed from 2003-2005 and 2008-2010.
  • Data included 31,709 deliveries, with OASIS incidence and risk factors analyzed using logistic regression.

Main Results:

  • The incidence of OASIS decreased by 50%, from 4% to 1.9%, after the training program implementation.
  • This reduction was consistent across subgroups, including parity, delivery method, and infant birth weight.
  • No significant changes in population characteristics or OASIS risk factors explained the observed reduction.

Conclusions:

  • The implemented training program for perineal protection significantly reduced OASIS incidence.
  • The positive impact of the training was observed across all studied subgroups of women.
  • The findings strongly suggest that improved perineal protection training is effective in reducing the risk of OASIS.
Abstract

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