Evaluation of French practices in the management and the follow-up of obstetric anal sphincter injuries (OASIS) - 19/12/24
Abstract |
Objective |
The aim was to assess the current management and follow-up of obstetric anal sphincter injuries in maternity wards in France at two levels: the patient's and the care unit level.
Study design |
We carried out an evaluation of professional practices in all French maternity hospitals by sending a questionnaire that covered five areas: (i) general information about the hospital, (ii) immediate management of OASIS and postpartum care, (iii) patient follow up, (iv) management of a subsequent pregnancy, and (v) training of health professionals.
Results |
During this period, 102 answers (22.4%) were obtained. Forty-five maternity hospitals (44.1%) did not have a dedicated protocol for the management and the follow-up of OASIS. In four maternities (4%), the resident or midwife repaired the anal sphincter alone. Ninety-eight percent of the obstetricians repaired the external anal sphincter using either the end-to-end or overlap techniques. Only two maternities (2%) used postpartum symptom or quality of life questionnaires after OASIS. In the post-partum, in ten (9.8%) maternities, patients attended a consultation with an urogynecologist. In this study, 57.8% patients did not have an anal sphincter ultrasonography prescription in their follow-up even though they had symptoms.
Conclusion |
We observed a great heterogeneity in the management of patients with OASIS in French maternity hospitals. National guidelines and regular training of health professionals are required to improve this management.
Le texte complet de cet article est disponible en PDF.Keywords : Obstetrical anal sphincter injuries, questionnaire, survey, professional practice assessment, France, management
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