Is the Outcome Indicator “3rd/4th Degree Perineal Tear in Spontaneous Singleton Births” a Reliable Quality Parameter in Obstetrics?

Abstract

Obstetric sphincter damage is the most common cause of fecal incontinence in women. Between one-third and two-thirds of women who sustain a recognized third-degree tear during delivery subsequently suffer from fecal incontinence. We should therefore try to reduce the rate of high-grade tears as much as possible. But this rate can only be used as an outcome indicator for the quality of obstetric departments if the recognition and classification of sphincter injury is similar across departments in different hospitals.

Zusammenfassung

Eine Verletzung des analen Sphinkters stellt einen wesentlichen Risikofaktor für die Entwicklung einer analen Inkontinenz bei Frauen dar. Ein bis zwei Drittel der Frauen, bei denen unmittelbar nach der Entbindung ein Dammriss (DR) Grad III festgestellt wird, leiden an analen Inkontinenzsymptomen. Eine möglichst niedrige Rate höhergradiger Dammrisse ist deshalb anzustreben. Diese Rate ist als Ergebnisindikator zur Beschreibung der Qualität einer geburtshilflichen Abteilung aber nur dann verwendbar, wenn eine vergleichbare Qualität der Wahrnehmung und Klassifizierung von analen Sphinkterverletzung in den Abteilungen besteht.

Key words

delivery - fecal incontinence - tear - external anal sphincter - quality

Schlüsselwörter

Geburt - anale Inkontinenz - Dammriss - externer analer Sphinkter - Qualität

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