PDF(Pubmed)
Abstract：
OBJECTIVE: Perineal trauma during vaginal delivery is very common. Training in diagnosis and repair of trauma, including obstetric anal sphincter injuries, varies in the UK. We aimed to investigate the current knowledge and training received by obstetric physicians.
METHODS: A national, validated survey was conducted online, using Qualtrics. The National Trainees Committee distributed the survey. It was also sent directly to consultants via email.
RESULTS: A total of 302 physicians completed the survey and were included in the analysis. 3.9% of participants described their training in obstetric perineal trauma as \"very poor\" or \"poor\". 20.5% said they have not received training. 8.6% of physicians practising for more than 10 years had not had training for over 10 years. 70.5% responded \"somewhat agree\" or \"strongly agree\" when asked if they would like more training. Identification of first, second, third-, and fourth-degree tears from images and descriptions was very good (more than 80% correct for all categories). Classification of other perineal trauma was less consistent, with many incorrectly using the Sultan Classification. \"Manual perineal support\" and \"Controlled or guided delivery\" were the most frequently selected methods for the prevention of obstetric anal sphincter injury (OASI).
CONCLUSIONS: Training experience for physicians in obstetric perineal trauma varies. Further improvement in training and education in perineal trauma, particularly in OASI, is needed for physicians. Perineal trauma that is not included in the Sultan Classification is often misclassified.
METHODS: A national, validated survey was conducted online, using Qualtrics. The National Trainees Committee distributed the survey. It was also sent directly to consultants via email.
RESULTS: A total of 302 physicians completed the survey and were included in the analysis. 3.9% of participants described their training in obstetric perineal trauma as \"very poor\" or \"poor\". 20.5% said they have not received training. 8.6% of physicians practising for more than 10 years had not had training for over 10 years. 70.5% responded \"somewhat agree\" or \"strongly agree\" when asked if they would like more training. Identification of first, second, third-, and fourth-degree tears from images and descriptions was very good (more than 80% correct for all categories). Classification of other perineal trauma was less consistent, with many incorrectly using the Sultan Classification. \"Manual perineal support\" and \"Controlled or guided delivery\" were the most frequently selected methods for the prevention of obstetric anal sphincter injury (OASI).
CONCLUSIONS: Training experience for physicians in obstetric perineal trauma varies. Further improvement in training and education in perineal trauma, particularly in OASI, is needed for physicians. Perineal trauma that is not included in the Sultan Classification is often misclassified.
摘要：
目的：阴道分娩过程中会阴损伤非常常见。创伤诊断和修复培训，包括产科肛门括约肌损伤,在英国有所不同。我们旨在调查产科医师目前接受的知识和培训。
方法：国家，经过验证的调查是在网上进行的，使用Qualtrics。全国受训人员委员会分发了调查。它也通过电子邮件直接发送给顾问。
结果：共有302名医生完成了调查并纳入分析。3.9%的参与者将他们在产科会阴创伤方面的训练描述为“非常差”或“差”。20.5％的人表示他们没有接受过培训。超过10年的医生中有8.6％的医生没有接受过10年以上的培训。当被问及是否想要更多培训时，70.5%的人回答“有点同意”或“强烈同意”。识别第一,第二,第三，图像和描述的四度眼泪非常好（所有类别的正确率超过80％）。其他会阴创伤的分类不太一致，许多人错误地使用了苏丹分类。“手动会阴支持”和“控制或引导分娩”是预防产科肛门括约肌损伤（OASI）的最常用方法。
结论：医生在产科会阴创伤方面的培训经验各不相同。进一步改善会阴创伤的培训和教育，尤其是在OASI,是医生需要的。苏丹分类中未包括的会阴创伤通常被错误分类。
方法：国家，经过验证的调查是在网上进行的，使用Qualtrics。全国受训人员委员会分发了调查。它也通过电子邮件直接发送给顾问。
结果：共有302名医生完成了调查并纳入分析。3.9%的参与者将他们在产科会阴创伤方面的训练描述为“非常差”或“差”。20.5％的人表示他们没有接受过培训。超过10年的医生中有8.6％的医生没有接受过10年以上的培训。当被问及是否想要更多培训时，70.5%的人回答“有点同意”或“强烈同意”。识别第一,第二,第三，图像和描述的四度眼泪非常好（所有类别的正确率超过80％）。其他会阴创伤的分类不太一致，许多人错误地使用了苏丹分类。“手动会阴支持”和“控制或引导分娩”是预防产科肛门括约肌损伤（OASI）的最常用方法。
结论：医生在产科会阴创伤方面的培训经验各不相同。进一步改善会阴创伤的培训和教育，尤其是在OASI,是医生需要的。苏丹分类中未包括的会阴创伤通常被错误分类。
