Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury : An observational study
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Kaijomaa , M , Gissler , M , Äyräs , O , Sten , A & Grahn , P 2023 , ' Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury : An observational study ' , BJOG : An International Journal of Obstetrics & Gynaecology , vol. 130 , no. 1 , pp. 70-77 . https://doi.org/10.1111/1471-0528.17278
| Title: | Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury : An observational study |
| Author: | Kaijomaa, Marja; Gissler, Mika; Äyräs, Outi; Sten, Assi; Grahn, Petra |
| Contributor organization: | HUS Gynecology and Obstetrics Department of Obstetrics and Gynecology Clinicum University of Helsinki HUS Children and Adolescents Helsinki University Hospital Area Children's Hospital |
| Date: | 2023-01 |
| Language: | eng |
| Number of pages: | 8 |
| Belongs to series: | BJOG : An International Journal of Obstetrics & Gynaecology |
| ISSN: | 1470-0328 |
| DOI: | https://doi.org/10.1111/1471-0528.17278 |
| URI: | http://hdl.handle.net/10138/352510 |
| Abstract: | Objective To study the impact of shoulder dystocia (SD) simulation training on the management of SD and the incidence of permanent brachial plexus birth injury (BPBI). Design Retrospective observational study. Setting Helsinki University Women's Hospital, Finland. Sample Deliveries with SD. Methods Multi-professional, regular and systematic simulation training for obstetric emergencies began in 2015, and SD was one of the main themes. A study was conducted to assess changes in SD management and the incidence of permanent BPBI. The study period was from 2010 to 2019; years 2010-2014 were considered the pre-training period and years 2015-2019 were considered the post-training period. Main outcome measures The primary outcome measure was the incidence of permanent BPBI after the implementation of systematic simulation training. Changes in the management of SD were also analysed. Results During the study period, 113 085 vertex deliveries were recorded. The incidence of major SD risk factors (gestational diabetes, induction of labour, vacuum extraction) increased and was significantly higher for each of these factors during the post-training period (p < 0.001). The incidence of SD also increased significantly (0.01% vs 0.3%, p < 0.001) during the study period, but the number of children with permanent BPBI decreased by 55% after the implementation of systematic simulation training (0.05% vs 0.02%, p < 0.001). The most significant change in the management of SD was the increased incidence of successful delivery of the posterior arm. Conclusions Systematic simulation-based training of midwives and doctors can translate into improved individual and team performance and can significantly reduce the incidence of permanent BPBI. |
| Subject: |
birth
caesarean emergency multi-professional simulation-based training permanent brachial plexus birth injury shoulder dystocia management trauma RISK-FACTORS OBSTETRIC SKILLS PALSY COMPLICATIONS PREVALENCE Birth Caesarean Trauma Shoulder dystocia management Multi-professional simulation-based training Permanent brachial plexus birth injury Emergency 3123 Gynaecology and paediatrics |
| Peer reviewed: | Yes |
| Rights: | cc_by_nc_nd |
| Usage restriction: | openAccess |
| Self-archived version: | publishedVersion |
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