Poster Session 2
Category: Labor
Poster Session 2
Minhazur R. Sarker, MD
Fellow Physician
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Rachel L. Wiley, MD, MPH (she/her/hers)
Maternal Fetal Medicine Fellow
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Dana R. Canfield, MD
Maternal Fetal Medicine Fellow
Department of Obstetrics & Gynecology , University of Washington, Seattle, WA
Seattle, Washington, United States
Yalda Afshar, MD, PhD (she/her/hers)
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Kelsey Rose, MD
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Scott Harvey, MD, MS
Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego
San Diego, California, United States
E. Nicole Teal, MD, MPH (she/her/hers)
Assistant Professor, Division of Maternal-Fetal Medicine
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Suboptimal repair of obstetric anal sphincter injuries (OASIS) is associated with complications such as repair breakdown, infection, incontinence, and worse quality of life. In current practice, obstetrics and gynecology trainees have less exposure to OASIS repairs. This study aims to characterize OASIS repair proficiency among maternal-fetal medicine (MFM) fellow physicians – a group of physicians obtaining additional training in clinical obstetrics.
Study Design:
We conducted a cross-sectional survey of MFM fellows between January to June 2025. The survey was distributed primarily by email to fellows, program directors, and program coordinators. The primary outcome was fellow comfort with OASIS repairs (3rd degree or 4th degree. Secondary outcomes included training characteristics and perception of respective programs’ training adequacy. This study was deemed exempt by the Institutional Review Board.
Results:
Of the 411 fellows, 162 (39.4%) responded with no differences in fellowship year, region, or type of institution. Among respondents, 93.8% participated in OASIS repair simulations and felt they were helpful (Table 1). More than half of respondents (53.1%) reported repairing more than 10 3rd degree perineal lacerations and feeling comfortable teaching the repair (Table 2). Conversely, only 26.5% of respondents reported repairing 5 or more 4th degree perineal lacerations and less comfort with teaching this skill (Table 2). While 92.6% of respondents felt residency provided adequate 3rd degree repair training, only 62.4% felt similarly for 4th degree repair training (Table 2). Moreover, only 61.7% and 38.3% of respondents felt fellowship provides adequate training for 3rd and 4th degree perineal lacerations, respectively (Table 2).
Conclusion:
While the majority of MFM fellows are comfortable repairing 3rd degree lacerations, over a quarter did not feel comfortable repairing 4th degree lacerations without supervision. There is a clear need to develop pathways for improvement in OASIS repair such as simulation models or workshops.