Obstetrics and Gynecology International / 2012 / Article / Tab 4

Clinical Study

Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

Table 4


Affiliation (mark with a cross)

1Year of residenceR3R4
2HospitalLevel IILevel III
3Number of births/year (2006)
4Number of residents/year

Evaluation on the knowledge of anatomy (mark with a cross)

6Do you think you have adequate knowledge of the pelvic floor anatomy?YESNO
7Do you know the name of the various muscles of the pelvic floor?YESNO
8Are you able to recognize the various muscles of the pelvic floor during digital vaginal examination?YESNO
9Are you able to identify the tendinous arc of the anus levator during digital vaginal examination?YESNO
10Can you identify the sciatica spines during digital vaginal examination?YESNO
11Do you know the path of the pudenda nerve, and are you able to inject the anaesthetics in it?YESNO

Evaluation on the knowledge of episiotomy (mark with a cross)

12Do you know when an episiotomy would be indicated?YESNO
13Are you familiar with the suture of the various types of episiotomy (medial, medial lateral)?YESNO
14Do you know when the medial episiotomy is counter indicated?YESNO
15Does your centre apply a selective policy for episiotomy?YESNO
16Do you think a selective policy for episiotomy is positive?YESNO

Evaluation on the knowledge of the perineal tears (mark with a cross or rate from 0 to 5)

17Do you know the definition of grades III and IV perineal tears?YESNO

Classification of perineal tears grade I: affects the vaginal mucosa and the connective tissue; grade II: affects the underlying muscles in addition; grade III: anal sphincter rupture; grade IV: affects the rectal mucosa

18Do you feel able to carry out a C-section? (rate from 0 to 5)
19Do you feel able to repair a grade III or IV perineal tear? (rate from 0 to 5)
20How many grade III or IV perineal tears have you repaired?0–10 10–20>20
21Can you distinguish between a grade III and a grade IV perineal tear during the usual practice?YESNO
22Do you know more than one technique to repair an anal sphincter injury?YESNO
23Do you know when prophylactic antibiotics should be administered after a tear?YESNO

Evaluation on teaching (mark with a cross)

24Do you feel competent when repairing a perineal tear?YESNO
25Do you usually followup on a puerpera who has suffered a grade III or IV perineal tear after discharge (followup, pain level, sexual and anal dysfunctions)?YESNO
26Do you know if there is any difference in the risk of urinary and faecal incontinence after birth (due to mechanical lesion) depending on whether the birth is spontaneous or instrumental?YESNO
27Do you know if any of the instruments (spatules, forceps, vacuum pads) have higher associated risk or are their risks equivalent?YESNO
28Did you have a teaching assistant help during your suture in your first perineal tear repair?YESNO
29Did an assistant supervise/help you on subsequent occasions?YESNO
30Or did a major resident, in the absence of assistants?YESNO
31Do you think that you received adequate supervision when faced with a grade III or IV perineal tear?YESNO
32Do you think you can teach a minor resident to repair a grade III or IV perineal tear, in practice?YESNO
33Have you received formal training on pelvic anatomy or on the repair f perineal lacerations, within your training programme?YESNO
34Have you received theoretical training in any clinical session, videos, articles offered by any assistant?YESNO
35Have you read books, articles related to pelvic anatomy, perineal tears, episiotomy, surgical techniques for repairs, and so forth?YESNO
36Have you received any theoretical-practical training with corpses?YESNO
37Do you think you need to receive more supervision by an assistant or major resident to repair grade III or IV perineal tears?YESNO
38Do you think you need more theoretical training on it?YESNO
39Do you think a theoretical-practical course on the anatomy of he pelvic floor and the repair of its lesions would be useful?YESNO
40Would you give the same replies if you reread the questions after some minutes?YESNO

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