{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:48:16Z","timestamp":1789177696237,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,12,30]],"date-time":"2014-12-30T00:00:00Z","timestamp":1419897600000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the views of a multidisciplinary group of experts and achieve consensus on the importance of perineal support in preventing obstetric anal sphincter injuries (<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A three\u2010generational Delphi survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\u2010wide survey of experts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A panel of 20 members consisting of obstetricians, midwives and urogynecologists recommended by<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>professional bodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 58\u2010item web\u2010based questionnaire was sent to all participants who were asked to anonymously rate the importance of each item on a six\u2010point Likert scale. They were asked to rate their level of agreement on statements related to hands\u2010on\/hands\u2010poised techniques, the association of hands\u2010poised\/hands\u2010off approach with<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>, the need to implement perineal support and the need to improve the evidence to support it. Systematic feedback of responses from previous rounds was provided to participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>To achieve consensus on key areas related to perineal support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The response rate was 100% in all three iterations. There was consensus that current<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>practice regarding perineal protection was not based on robust evidence. The respondents agreed that hands\u2010poised\/hands\u2010off and<jats:styled-content style=\"fixed-case\">OASIS<\/jats:styled-content>are causally related and that hands\u2010poised was misinterpreted by clinicians as hands\u2010off. Although 90% of experts agreed that some form of randomized trial was required and that all would be prepared to take part, there was also consensus (75%) that in the meantime, hands\u2010on should be the recommended technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results highlight the current lack of evidence to support policies of perineal support at time of birth and the need to address this controversial issue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12547","type":"journal-article","created":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T14:41:33Z","timestamp":1416840093000},"page":"165-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Perineal support and risk of obstetric anal sphincter injuries: a Delphi survey"],"prefix":"10.1111","volume":"94","author":[{"given":"Khaled M. 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