ACOG Committee Opinion No. 647 Summary: Limitations of Perineal Lacerations as an Obstetric Quality Measure.

Abstract:

:Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for the following three reasons: 1) third-degree and fourth-degree perineal lacerations may not be defined uniformly; 2) severe perineal lacerations are associated strongly with nonmodifiable risk factors; and 3) diminishing the use of operative vaginal delivery, in an effort to decrease severe perineal lacerations, likely would result in an increased rate of cesarean delivery. Measuring the rate of episiotomy with unassisted vaginal deliveries is an alternative candidate for quality measurement, but it requires validation before widespread implementation.

journal_name

Obstet Gynecol

authors

Committee on Obstetric Practice.

doi

10.1097/AOG.0000000000001146

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

1129

issue

5

eissn

0029-7844

issn

1873-233X

pii

00006250-201511000-00049

journal_volume

126

pub_type

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