{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T04:19:03Z","timestamp":1729916343059,"version":"3.28.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the impact of Triepi\u201045\u2014a tool that enables an episiotomy angle of 45\u00b0 to be marked on the perineum at rest\u2014on the incidence of obstetric anal sphincter injuries (<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>) during operative vaginal delivery (<jats:styled-content style=\"fixed-case\">OVD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective\u2013prospective cohort study was performed among successive women who underwent <jats:styled-content style=\"fixed-case\">OVD<\/jats:styled-content> at Complejo Asistencial Universitario de de Le\u00f3n, Spain, between 2011 and 2013 (preintervention cohort, n=986) and between 2014 and 2016 (intervention cohort, n=986) after implementation of an interventional programme in 2013 to improve the episiotomy angle, including use of Triepi\u201045, in <jats:styled-content style=\"fixed-case\">OVD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intervention cohort had a lower incidence of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> than the preintervention cohort (70\/986 [7.1%] vs 93\/986 [9.4%]), but the difference was not significant, owing to the low use of Triepi\u201045 in the intervention cohort (n=375). However, the <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> incidence was significantly lower in the Triepi\u201045 cohort than in the preintervention cohort (18\/375 [4.8%] vs 93\/986 [9.4%]; odds ratio, 0.47; 95% confidence interval, 0.26\u20130.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Use of Triepi\u201045 had a positive impact on reducing <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">OVD<\/jats:styled-content>. It remains essential to raise obstetricians\u2019 awareness of the importance of the episiotomy angle and to implement the systematic use of tools to reduce the incidence of <jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13055","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T07:24:01Z","timestamp":1573802641000},"page":"231-237","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of obstetric anal sphincter injuries after implementing the Triepi\u201045 tool to improve episiotomy angle in instrumental deliveries"],"prefix":"10.1002","volume":"148","author":[{"given":"Enrique","family":"Gonzalez\u2010D\u00edaz","sequence":"first","affiliation":[{"name":"Pelvic Floor Unit Department of Obstetrics and Gynecology Complejo Asistencial Universitario de Le\u00f3n  Le\u00f3n Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camino","family":"Fern\u00e1ndez Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Complejo Asistencial Universitario de Le\u00f3n  Le\u00f3n Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Manuel","family":"Gonzalo Orden","sequence":"additional","affiliation":[{"name":"Instituto de biomedicina de Le\u00f3n University of Leon  Le\u00f3n Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Fern\u00e1ndez Corona","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Complejo Asistencial Universitario de Le\u00f3n  Le\u00f3n Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1136\/bmj.308.6933.887"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1007\/s10350-004-0887-2"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1097\/AOG.0b013e3181eda77a"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1111\/j.1471-0528.2001.00090.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1067\/mob.2003.547"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1007\/s00192-005-1297-2"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1016\/S0002-9378(99)70104-3"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1016\/j.ajog.2006.06.078"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1111\/j.1471-0528.2007.01554.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1016\/j.ajog.2012.02.008"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1111\/j.1471-0528.2012.03455.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1016\/j.ijgo.2007.07.022"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1111\/j.1471-0528.2003.03030.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1111\/j.1471-0528.2005.00645.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.3109\/14767058.2015.1086328"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1111\/j.1471-0528.2012.03293.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1111\/j.1471-0528.2005.00835.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_19_1","DOI":"10.1007\/s00192-014-2491-x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_20_1","DOI":"10.1016\/j.ejogrb.2018.12.019"},{"doi-asserted-by":"publisher","key":"e_1_2_8_21_1","DOI":"10.1007\/s00192-016-3166-6"},{"doi-asserted-by":"publisher","key":"e_1_2_8_22_1","DOI":"10.1016\/j.ijgo.2008.05.026"},{"doi-asserted-by":"publisher","key":"e_1_2_8_23_1","DOI":"10.1016\/j.ijgo.2010.09.015"},{"key":"e_1_2_8_24_1","first-page":"308","article-title":"Third degree obstetric anal sphincter tears: Risk factors and outcome of primary repair","volume":"2","author":"Sultan AH","year":"1994","journal-title":"BMJ"},{"doi-asserted-by":"publisher","key":"e_1_2_8_25_1","DOI":"10.1056\/NEJMra1614394"},{"doi-asserted-by":"publisher","key":"e_1_2_8_26_1","DOI":"10.7326\/M17-0046"},{"doi-asserted-by":"publisher","key":"e_1_2_8_27_1","DOI":"10.1007\/s00192-015-2625-9"},{"doi-asserted-by":"publisher","key":"e_1_2_8_28_1","DOI":"10.1016\/j.midw.2014.08.009"},{"key":"e_1_2_8_29_1","first-page":"23","article-title":"Cutting a mediolateral episiotomy at the correct angle: Evaluation of a new device, the Episcissors\u201060","volume":"7","author":"Freeman RM","year":"2014","journal-title":"Med Devices (Auckl)"},{"doi-asserted-by":"publisher","key":"e_1_2_8_30_1","DOI":"10.1007\/s00192-019-03901-4"}],"container-title":["International Journal of Gynecology &amp; 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