Pelvic + Anatomy: A new interactive pelvic anatomy model. Prospective randomized control trial with first-year midwife residents.

Detailed knowledge of female pelvic floor anatomy is essential for midwifery and other professionals in obstetrics. Physical models have shown great potential for teaching anatomy and enhancing surgical skills. In this article, we introduce an innovative physical anatomy model called "Pelvic+" to teach anatomical relationships in the female pelvis. The Pelvic+ model's value was compared to a traditional lecture in 61 first-year midwifery students randomly allocated to either the Pelvic+ (n = 30) or a control group (n = 32). The primary outcome measure was a quiz comprised of 15 multiple choice questions on pelvic anatomy. Participants were assessed at baseline (Pre-Test), upon completion of the intervention (Post-Test1) and 4 months afterward (Post-Test2). Satisfaction with the approach was assessed at Post-Test1. Increase in knowledge was greater and the approach more accepted among resident midwives when Pelvic+ was used instead of standard lectures. Four months after the intervention, the improvement in knowledge was preserved in the Pelvic+ group. This randomized study demonstrates that the Pelvic+ simulator is more effective than classical learning for pelvic anatomy education, and offers a higher level of satisfaction among students during the educational process. Medical students training in obstetrics and gynecology, or any professional who specializes in the female pelvic floor might also benefit from incorporation of the Pelvic+ model into their training program.

Cuidado de las lesiones posparto en la consulta perineal / The role of a specialist clinic to care for childbirth related perineal trauma

El objetivo de este artículo fue revisar bibliográficamente los principales problemas que se derivan de las lesiones perineales, así como dar a conocer el trabajo de la matrona en una consulta perineal y el modo en que se está implementando esta consulta en el Hospital General de Granollers. Para cumplir con la primera parte del objetivo, se realizó una revisión bibliográfica sobre las complicaciones derivadas de las lesiones perineales que ocurren durante el parto. Los resultados obtenidos se han estructurado en los siguientes apartados: dolor perineal y dispareunia, infección y dehiscencia, incontinencia urinaria y prolapso genital (lesión del músculo elevador del ano) e incontinencia fecal y de gases (lesión del esfínter anal). En la segunda parte del artículo se explica la experiencia que se realizó en el Servicio de Obstetricia del Hospital de Granollers para disminuir la morbilidad posparto derivada de las lesiones perineales. Se implementaron diversas medidas de prevención, y se creó una consulta perineal para dar continuidad a los cuidados especializados para las mujeres que han sufrido alguna complicación perineal tras el parto vaginal. La matrona, integrada en el equipo multidisciplinario especialista en suelo pélvico, es la profesional que realiza este seguimiento y proporciona apoyo a la mujer

The objectives of this paper are twofold. Firstly, to review the morbidity associated with childbirth related perineal trauma (CRPT), and secondly, to outline the role of the Specialist Perineal Midwife and their integral role within a new Midwife-led Perineal Clinic in Hospital General de Granollers, Barcelona to care for women and reduce CRPT morbidity. The first part of this paper details the findings from a review of the literature on the CRPT morbidities of perineal pain and dyspareunia; perineal wound infection and breakdown; urinary incontinence and genital prolapse (levator ani muscle injury), and fecal incontinence (anal sphincter injury). The second part of this paper details the actions that have been implemented in the Obstetrics Service of the Hospital General de Granollers in order to reduce postpartum morbidity related to perineal injuries. These include the provision of a specialist perineal midwife who, through a dedicated perineal clinic, provides specialist care for women who suffer CRPT and is a core member of the perineal trauma/OASIS multi-disciplinary team