We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Impact of animated instruction on tablets and hands-on training in applying bimanual perineal support on episiotomy rates: an intervention study.
- Authors
Zimmo, Kaled Mikki; Laine, Katariina; Fosse, Erik; Zimmo, Mohammed; Ali-Masri, Hadil; Böttcher, Bettina; Zucknick, Manuela; Vikanes, Åse; Hassan, Sahar
- Abstract
Introduction and hypothesis: In Palestine, episiotomy is frequently used among primiparous women.This study assesses the effect of training birth attendants in applying bimanual perineal support during delivery by either animated instruction on tablets or hands-on training on episiotomy rates among primiparous women. Methods: An interventional cohort study was performed from 15 October 2015 to 31 January 2017, including all primiparous women with singletons and noninstrumental vaginal deliveries at six Palestinian hospitals. Intervention 1 (animated instructions on tablets) was conducted in Hospitals 1, 2, 3, and 4. Intervention 2 (bedside hands-on training) was applied in Hospitals 1 and 2 only. Hospitals 5 and 6 did not receive interventions. Differences in episiotomy rates in intervention and nonintervention hospitals were assessed before and after the interventions and presented as p values using chi-square test, and odds ratios (OR) with 95% confidence intervals (CI). Differences in the demographic and obstetric characteristics were presented as p values using the Kruskal–Wallis test. Results: Of 46,709 women, 12,841 were included. The overall episiotomy rate in the intervention hospitals did not change significantly after intervention 1, from 63.1 to 62.1% (OR = 0.96, 95% CI 0.84–1.08), but did so after intervention 2, from 61.1 to 38.1% (OR = 0.39, 95% CI 0.33–0.47). Rates after Intervention 2 changed from 65.0 to 47.3% (OR = 0.52, 95% CI 0.40–0.67) in Hospital 1 and from 39.4 to 25.1% (OR = 0.49, 95% CI 0.35–0.68) in Hospital 2. Conclusions: Hands-on training of bimanual perineal support during delivery of primiparous women was significantly more effective in reducing episiotomy rates than animated instruction videos alone.
- Subjects
PALESTINE; MIDWIVES; RATINGS of hospitals; EPISIOTOMY; DEMOGRAPHIC characteristics; KRUSKAL-Wallis Test
- Publication
International Urogynecology Journal, 2019, Vol 30, Issue 8, p1343
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-018-3711-6