Nygaard Christiana C, Tsiapakidou Sofia, Pape Janna, Falconi Gabriele, Betschart Cornelia, Pergialiotis Vasilios, Doumouchtsis Stergios K
Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom; Department of Obstetrics and Gynecology, Hospital Sao Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
1st Department of Obstetrics and Genecology, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Eur J Obstet Gynecol Reprod Biol. 2020 Apr;247:66-72. doi: 10.1016/j.ejogrb.2020.01.049. Epub 2020 Feb 3.
Pelvic floor trauma during childbirth is highly prevalent and is associated with long term risks of incontinence and pelvic organ prolapse. Societies and organizations have published clinical guidelines in order to standardise and improve the management of perineal care. The aim of this study was to systematically evaluate the quality of clinical guidelines on obstetric perineal trauma and care using the AGREE II instrument. We searched Medline, PubMed, Web of Science and ScienceDirect databases from inception until the 15th of December 2018 using the terms "guideline" OR "guidelines", OR "guidance", OR "recommendation" AND "obstetric anal sphincter injury", OR "perineal laceration" OR "perineal tear" OR "perineal trauma" OR "vaginal tear". Twelve guidelines were included, in English and Spanish.The assessment of the guidelines was performed using AGREE II by 5 appraisers.Ten guidelines scored more than 50 %, and 3 of them scored higher than 70 %. Two guidelines scored <50 % and were considered as low quality. Level of evidence and grade of recommendations were used by 7 guidelines of the 12 guidelines. Although some guidelines received high scores, there is space for improvement of the standards of guidelines.
分娩期间的盆底创伤非常普遍，并且与尿失禁和盆腔器官脱垂的长期风险相关。各协会和组织已发布临床指南，以规范和改进会阴护理的管理。本研究的目的是使用AGREE II工具系统评价产科会阴创伤及护理临床指南的质量。我们检索了Medline、PubMed、Web of Science和ScienceDirect数据库，检索时间从建库至2018年12月15日，检索词为“指南”或“导则”或“指导”或“推荐”以及“产科肛门括约肌损伤”或“会阴裂伤”或“会阴撕裂”或“会阴创伤”或“阴道撕裂”。共纳入12篇英文和西班牙文指南。由5名评估人员使用AGREE II对这些指南进行评估。10篇指南得分超过50%，其中3篇得分高于70%。2篇指南得分<50%，被视为低质量。12篇指南中有7篇使用了证据级别和推荐等级。尽管一些指南获得了高分，但指南的标准仍有改进空间。
