May 28th, 2018

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Obstetric Laceration Repair in the United States: Is There a Common Practice?
Authors:  Arielle M. Allen, D.O., S. Abbas Shobeiri, M.D., Lieschen H. Quiroz, M.D., D. Nelson Fong, M.D., and Mikio A. Nihira, M.D., M.P.H.
  OBJECTIVE: To assess practice preferences in the repair of severe obstetric lacerations among obstetrician/gynecologists in the United States.

STUDY DESIGN: A survey detailing third and fourth degree laceration repair techniques was distributed to 634 obstetrician/gynecologists from demographically diverse areas of the United States. Categorical outcomes were compared among respondents using c2 or Fisher’s exact test where appropriate.

RESULTS: Of the 266 respondents, there were 124 self-reported “experts” (47%) and 106 physicians-in-training (40%). Repair techniques were compared between experts versus nonexperts and trainees versus practicing physicians. There were no significant differences found between either comparison group on the type and size of suture utilized or preferred method of closure for repair.

CONCLUSION: There is little variation in the practice pattern of complex laceration repairs among obstetrician-gynecologists in the United States. This commonality should encourage the design of standard teaching models and techniques for physicians in training.
Keywords:  anal sphincter laceration, episiotomy, fourth degree laceration, obstetric laceration, obstetric surgical procedures, obstetrics, perineal laceration, standard of care, third degree laceration
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