Gynecol Obstet Fertil Senol 2019 Jun 16;47(6):504-509. Epub 2019 Apr 16.
Pôle de gynécologie-obstétrique, CHRU de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; Inserm U1254, CHRU de Nancy, rue du Morvan, 54000 Vandœuvre-lès-Nancy, France.
Objectives: The main objective was to evaluate the practices declared by birth professionals in the Lorraine region about perineal obstetric protection (any perineal tear combined). The secondary objective was to evaluate prevention measures performed in practice by birth professionals according to the perineal risk subjectively estimated for each obstetric situation.
Methods: This is a practice survey conducted through an anonymous questionnaire distributed to birth professionals (gynecologists, interns, midwife and midwife student) in October 2016. Topics covered concerned maternal, obstetric and fetal risk factors associated with perineal (1st to 4th degrees) lesions and the associated protective measures. A descriptive analysis of the data collected was conducted.
Results: One hundred and five professionals answered the questionnaire. The identified risk factors were consistent with those highlighted in the literature. Other factors, not known as associated with perineal risk, were cited by professionals (smoking, phototype). If the professional perceived a significant perineal risk, they more frequently practiced an episiotomy (15% vs. 0%, P<0.001) or considered that the delivery should be performed by an obstetrician (34% vs 8%, P<0.001).
Conclusion: This evaluation shows that birth professionals know the main risk factors for perineal injury. On the other hand, they easily use perineal protection maneuvers (episiotomy for example) without real demonstrated effectiveness.