ArticleBMC medical education2018
Impact of electronic and blended learning programs for manual perineal support on incidence of obstetric anal sphincter injuries: a prospective interventional study.
Article in BMC medical education, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02427854 (Can Perineal Tears and Obstetric Anal Sphincter Injuries in Palestine be Prevented? A Study of Two Different Interventions), which is not on this map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Can Perineal Tears and Obstetric Anal Sphincter Injuries in Palestine be Prevented? A Study of Two Different Interventions
Who cites it
8 citing papers in PubMed.
- Self-directed learning by video as a means to improve technical skills in surgery residents: a randomized controlled trial.BMC medical education · 2021Trial
- Secular Trends in Recurrent Obstetric Anal Sphincter Injuries among 297,190 Women in Norway: A Cohort Study.International urogynecology journal · 2026Article
- Birth and Regulation of head Extension to Guide Manual perineal Assistance (BREGMA) study: a prospective cohort study.BMC pregnancy and childbirth · 2025Article
- The effect of postpartum nursing guidance on early pelvic floor dysfunction recovery in women of advanced maternal age: a randomized controlled trial.Frontiers in medicine · 2024Article
- The Efficacy of Blended Learning in a Pediatric Spine Deformity Management Program in Sub-Saharan Africa.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Aspects of Pelvic Floor Protection in Spontaneous Delivery - a Review.Geburtshilfe und Frauenheilkunde · 2022Article
- Blended Learning Is a Feasible and Effective Tool for Basic Pediatric Spinal Deformity Training.Global spine journal · 2021Article
- Metrics of perineal support (MOPS) study.BMC pregnancy and childbirth · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundObstetric anal sphincter injuries (OASIS) are associated with anal incontinence, dyspareunia and perineal pain. Bimanual perineal support technique (bPST) prevents OASIS. The aim of this study was to assess the effect of two different bPST training-methods on OASIS incidence.
methodsThis is a prospective-interventional quality improvement study conducted in two Palestinian maternity units between June 1 2015 and December 31 2016. Women having spontaneous or operative vaginal-delivery at ≥24 gestational-weeks or a birthweight of ≥1000 g (n = 1694) were recruited and examined vaginally and rectally immediately after vaginal birth by a trained assessor. Data on baseline OASIS incidence were collected during Phase-1 of the study. Subsequently, birth attendants in both maternity units were trained in bPST using two training modalities. A self-directed electronic-learning (e-learning) using an animated video was launched in phase-2 followed by a blended learning method (the animated e-learning video+ structured face-to-face training) in phase-3. OASIS incidence was monitored during phases-2 and 3. Variations in OASIS incidence between the three phases were assessed using Pearson-χ
resultsA total of 1694 women were included; 376 in phase-1, 626 in phase-2 and 692 in phase-3. Compared to Phase-1, OASIS incidence was reduced by 45% (12.2 to 6.7%, aOR: 0.56, CI; 0.35-0.91, p = 0.018) and 74% (12.2 to 3.2%, aOR, 0.29, CI; 0.17-0.50, p < 0.001) in phases-2 and 3, respectively. There was also a significant reduction in OASIS incidence by 52% from phase-2 to phase-3 (6.7% (42/626) to 3.2% (22/692), p = 0.003). These reductions reached statistical significance among parous-women only (aOR: 0.18, CI; 0.07-0.49, p = 0.001) after the first training method tested in phase-2. However, the reduction was significant among both primiparous (aOR: 0.39, CI; 0.21-0.74, p = 0.004) and parous-women (aOR: 0.11, CI; 0.04-0.32, p < 0.001) after implementing the blended learning method in phase-3.
conclusionThe animated e-learning video had a positive impact on reducing OASIS incidence. However, this reduction was enhanced by the use of a blended learning program combining both e- learning and face-to-face training modalities. STUDY REGISTRATION NUMBER: ClinicalTrialo.gov identifier: NCT02427854 , date: 28 April 2015.
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