A Dedicated Perineal Clinic – An Audit in Support

Area of Science:

• Obstetrics and Gynecology
• Surgical Patient Care

Background:

• Obstetric anal sphincter injury (OASI) is a significant complication of childbirth.
• Effective management and follow-up are crucial for women's recovery and long-term health.
• Tertiary maternity hospitals without dedicated perineal clinics may face challenges in providing optimal OASI care.

Purpose of the Study:

• To evaluate the quality of initial OASI management and subsequent postnatal follow-up.
• To compare care pathways with established national perineal clinics.
• To identify areas for improvement in OASI care within a tertiary maternity setting.

Main Methods:

• Retrospective review of medical records over a one-year period at University Maternity Hospital Limerick (UMHL).
• Analysis of patient demographics, OASI repair details, recorded complications, and postpartum follow-up.
• Comparison of the hospital's OASI care pathway with services offered by three national perineal clinics.

Main Results:

• Forty-four cases of OASI were recorded at UMHL within the study year.
• OASI predominantly affected primiparous women undergoing operative vaginal delivery (OVD).
• Only 23 out of 44 women (52%) received documented postnatal review.

Conclusions:

• Regular audit of OASI management is essential for maintaining high standards of care.
• Improved OASI care pathways and clinician training are necessary.
• The findings support the establishment of a dedicated perineal clinic at UMHL.