Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience

Area of Science:

• Obstetrics and Gynecology
• Surgical Safety
• Maternal Health

Background:

• Obstetric anal sphincter injuries (OASIs) are a significant cause of maternal morbidity.
• OASI rates have been increasing over the past decade, necessitating preventative strategies.

Purpose of the Study:

• To evaluate the effectiveness of a standardized perineal support technique in reducing the incidence and severity of OASIs during vaginal delivery.

Main Methods:

• Labor ward staff (midwives and doctors) received comprehensive training in perineal support.
• The technique was implemented for all spontaneous and assisted vaginal deliveries.
• Training included workshops, practical sessions, and ongoing departmental reinforcement.

Main Results:

• The overall OASI rate showed a non-significant decrease from 4.7% to 4.1%.
• A significant reduction was observed in major OASIs (third and fourth-degree tears), decreasing from 0.9% to 0.3%.
• Multivariate analysis confirmed perineal support was associated with a 23% reduction in OASIs and a 71% reduction in major OASIs.

Conclusions:

• Implementing perineal support during vaginal delivery is an effective intervention for reducing major OASIs.
• Sustained training and reinforcement of this technique are anticipated to further decrease OASI rates.
• This strategy holds potential for improving patient safety and reducing long-term maternal complications.