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International Urogynecology Journal

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15.03.2019 | Original Article

Prevention and Management of Severe Obstetric Anal Sphincter Injuries (OASIs): a National Survey of Nurse- Midwives

verfasst von: Sindi Diko, Maryam Guiahi, Amy Nacht, Kathleen A. Connell, Shane Reeves, Beth A. Bailey, K. Joseph Hurt

Erschienen in: International Urogynecology Journal | Ausgabe 3/2020

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Abstract

Introduction and hypothesis

There are no data on midwives’ knowledge and management of obstetric anal sphincter injuries (OASIs) in the USA. We performed a cross-sectional national survey characterizing OASI practice by certified nurse midwives (CNMs), hypothesizing that few midwives personally repair OASIs and that there are gaps in CNM OASI training/education.

Methods

We emailed a REDCap internet-based survey to 6909 American College of Nurse Midwives members (ACNM). We analyzed responses from active clinicians performing at least one delivery per month, asking about OASI risks, prevention, repair, and management. We summarized descriptive data then evaluated OASI knowledge by patient and provider characteristics.

Results

We received 1070 (15.5%) completed surveys, and 832 (77.8%) met the inclusion/exclusion criteria. Participants were similar to ACNM membership. Respondents most frequently identified prior OASI (87%) and nutrition (71%) as antepartum OASI risk factors and, less frequently, nulliparity (36%) and race (22%). Identified intrapartum risks included forceps delivery (94%) and midline episiotomy (88%). When obstetric laceration is suspected, 13.6% of respondents perform a rectal examination routinely. Only 15% of participants personally perform OASI repair. Overall, participants matched 64% of evidence-based answers. OASI education/training courses were attended by 30% of respondents, and 44% knew of OASI protocols within their group/institution. Of all factors evaluated, the percent of evidence-based responses was only different for respondent education/CME and protocols.

Conclusions

Quality initiatives regarding OASI prevention and management may improve care. Our data suggest OASI training for midwives may improve delivery care in the US. Further studies of other obstetric providers are needed.

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Titel: Prevention and Management of Severe Obstetric Anal Sphincter Injuries (OASIs): a National Survey of Nurse- Midwives
verfasst von: Sindi Diko
Maryam Guiahi
Amy Nacht
Kathleen A. Connell
Shane Reeves
Beth A. Bailey
K. Joseph Hurt
Publikationsdatum: 15.03.2019
Verlag: Springer International Publishing
Erschienen in: International Urogynecology Journal / Ausgabe 3/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-03897-x

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Springer Medizin

Prevention and Management of Severe Obstetric Anal Sphincter Injuries (OASIs): a National Survey of Nurse- Midwives

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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Springer Medizin

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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