Classification and management of extensive obstetric perineal injuries in the Czech and Slovak Republics

Objective: To assess the classification, repair, and follow up of extensive obstetric perineal injuries in the Czech and Slovak Republics.

Methods: A survey conducted in 2009 using questionnaires distributed to obstetric departments regarding classification and management of obstetric perineal injuries.

Results: Although 15 centers in the Czech Republic and 2 in the Slovak Republic indicated use of a 4-degree classification system, none of these centers reported using the classification accepted by the Royal College of Obstetricians and Gynaecologists. Use of a 3-degree classification system in accordance with definitions in Czech textbooks was reported by 14 Czech and 3 Slovak maternity hospitals. There was significant heterogeneity in clinical practice regarding techniques to repair extensive obstetric perineal injuries, antibiotic prophylaxis, early postpartum care, and follow up.

Conclusions: There is great inconsistency in the classification and management of extensive obstetric perineal injuries. Uniform recommendations should be created and accepted, not only in the Czech and Slovak Republics, but worldwide.