{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:57:08Z","timestamp":1759564628690,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"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":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Birth\u2010related third\u2010 and fourth\u2010degree perineal trauma is common and associated with short\u2010 and long\u2010term complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To conduct a review of clinical audits investigating management of women with perineal trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We identified all audits undertaken in eight New Zealand public hospitals between 2005 and 2014 that investigated whether women with birth\u2010related third\u2010 and fourth\u2010degree perineal trauma were receiving care according to clinical guidelines. We aggregated audit results and calculated the proportion of women receiving the recommended standard of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the review period, 25 audits investigated intra\u2010operative (<jats:italic>n<\/jats:italic>\u00a0=\u00a011), post\u2010operative (<jats:italic>n<\/jats:italic>\u00a0=\u00a014) and outpatient care (<jats:italic>n<\/jats:italic>\u00a0=\u00a018). Baseline audits showed variation in care by site; intra\u2010operative care (range 39\u201396% for repair conducted under anaesthesia, 60\u201396% for repair by or under supervision of a senior clinician, and 33\u201354% for completion of Accident Compensation Corporation forms); post\u2010operative care (range 40\u201393% for prescribed antibiotics and 33\u201396% for stool softeners) and outpatient care (45\u201384% for referral to outpatient clinic and 54\u201378% for physiotherapy follow\u2010up). Sustained high quality of care and improvements in adherence with recommendations were seen for most of the follow\u2010up audits (eg 90% adherence for prescribed stool softeners over three audits; over 50% increase in prescribed antibiotics over seven years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These clinical audits exemplify the need to measure patient care against standards, learn from the findings, implement changes to improve patient experience and reduce life\u2010long sequelae from perineal trauma. This review showed some progress in some care services and highlighted where further changes are needed to close evidence\u2010practice gaps.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13262","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T06:57:21Z","timestamp":1603436241000},"page":"22-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Perineal trauma management and follow\u2010up: Are we meeting the standard of care?"],"prefix":"10.1111","volume":"61","author":[{"given":"Roshini","family":"Peiris\u2010John","sequence":"first","affiliation":[{"name":"Section of Epidemiology and Biostatistics Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Yoo (Michelle)","family":"Park","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Wells","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Biostatistics Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2537-4688","authenticated-orcid":false,"given":"Bridget","family":"Kool","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Biostatistics Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9194-9585","authenticated-orcid":false,"given":"Michelle R.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Medicine Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"volume-title":"Greentop Guidelines No. 29. 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