Abstract
Objective
To reduce the incidence of third and fourth degree perineal tears.
Study design
This was a quality improvement project followed by an audit of outcomes. The population
consisted of all women delivering vaginally over a 12 month period following implementation
of the quality improvement measures. Following a review of clinical factors associated
with all third and fourth degree tears over a 3 month period and a review of relevant
evidence, a series of measures to try and reduce the incidence of such tears were
introduced. These measures were collectively known as STOMP (Stop Traumatic OASIS
Morbidity Project). These were adopted by all staff in our unit, with an accompanying
programme of workshops and a publicity campaign to promote staff engagement. Data
were collected on all third and fourth degree tears for a 12 month period following
project launch. The primary outcome was the incidence of third and fourth degree perineal
tears over a 12 month period.
Results
There were a total of 3902 vaginal births during the 12 month period following project
launch. Following full STOMP implementation, there was a significant decrease in the
incidence of third/fourth degree tears (4.7% vs 2.2%, p < 0.0001). The reduction was most pronounced in the first 5 months (4.7% vs 1.51%, p < 0.0001).
Conclusions
STOMP is a simple and low cost series of measures that has lead to a significant decrease
in the incidence of third and fourth degree tears in this cohort of women.
Keywords
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Article info
Publication history
Published online: April 29, 2016
Accepted:
April 23,
2016
Received in revised form:
March 29,
2016
Received:
November 30,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
