干旱区生态环境知识资源中心(Arid): Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician-gynecologists

Arid

DOI	10.1007/s00192-021-05062-9
	Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician-gynecologists
	Bunn, Jason G.; Sheeder, Jeanelle; Schulkin, Jay; Diko, Sindi; Estin, Miriam; Connell, Kathleen A.; Hurt, K. Joseph
通讯作者	Hurt, KJ
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2022
英文摘要	Introduction and hypothesis Obstetric lacerations complicate the majority of deliveries. The application of standardized guidelines for assessing delivery trauma has not been assessed thoroughly in the United States. We recently identified gaps in US midwives' clinical assessment of delivery trauma. We conducted a cross-sectional national survey of practicing obstetricians in the USA to characterize their classification of obstetric lacerations. We hypothesized that attending obstetricians' identification and diagnosis of delivery trauma would be similar to our findings for midwives with frequent inaccuracy. Methods We recruited clinically active obstetricians through the Pregnancy-Related Care Research Network. We asked participants to classify (from written definitions) and diagnose (from standard illustrations) common forms of vaginal delivery trauma using the widely employed perineal laceration degree system. We performed bivariate analysis of high- and low-scoring respondents and logistic regression to model characteristics associated with higher diagnostic accuracy. Results Of the 162 respondents who started the survey, 76% (123) were included for analysis (22% of solicited emails). Overall, we found wide variation in response accuracy with as few as 62% of respondents correctly classifying certain types of lacerations. Only 49 out of 123 (40%) use the Sultan third-degree subclassification system and 67 out of 123 (52%) continue to use the midline/median approach for episiotomies. Providers reporting fewer deliveries per month and fewer publicly insured patients earned higher scores. Conclusions Obstetricians in a nationally representative US perinatal provider network inconsistently identify perineal and nonperineal lacerations. We found important clinical knowledge gaps, suggesting that vaginal delivery diagnoses in obstetric quality studies and pelvic floor research might be inaccurate.
英文关键词	Laceration identification Laceration repair OASI Obstetric anal sphincter injury Obstetric trauma Perineal laceration
类型	Article ; Early Access
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000750691800001
WOS关键词	VAGINAL DELIVERY ; LACERATION ; QUALITY ; OASIS
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/377350
推荐引用方式 GB/T 7714	Bunn, Jason G.,Sheeder, Jeanelle,Schulkin, Jay,et al. Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician-gynecologists[J],2022.
APA	Bunn, Jason G..,Sheeder, Jeanelle.,Schulkin, Jay.,Diko, Sindi.,Estin, Miriam.,...&Hurt, K. Joseph.(2022).Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician-gynecologists.INTERNATIONAL UROGYNECOLOGY JOURNAL.
MLA	Bunn, Jason G.,et al."Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician-gynecologists".INTERNATIONAL UROGYNECOLOGY JOURNAL (2022).