Prevention of brachial plexus injury-12 years of shoulder dystocia training: an interrupted time-series study

Crofts, J. F., Lenguerrand, E., Bentham, G. L., Tawfik, S., Claireaux, H. A., Odd, D. ORCID: https://orcid.org/0000-0002-6416-4966, Fox, R. and Draycott, T. J. 2016. Prevention of brachial plexus injury-12 years of shoulder dystocia training: an interrupted time-series study. BJOG: An International Journal of Obstetrics and Gynaecology 123 (1) , pp. 111-118. 10.1111/1471-0528.13302

Full text not available from this repository.

Abstract

Objective To investigate management and outcomes of incidences of shoulder dystocia in the 12 years following the introduction of an obstetric emergencies training programme. Design Interrupted time‐series study comparing management and neonatal outcome of births complicated by shoulder dystocia over three 4‐year periods: (i) Pre‐training (1996–99), (ii) Early training (2001–04), and (iii) Late training (2009–12). Setting Southmead Hospital, Bristol, UK, with approximately 6000 births per annum. Population Infants and their mothers who experienced shoulder dystocia. Method A bi‐monthly multi‐professional 1‐day intrapartum emergencies training course, that included a 30‐minute practical session on shoulder dystocia management, commenced in 2000. Main Outcomes Neonatal morbidity (brachial plexus injury, humeral fracture, clavicular fracture, 5‐minute Apgar score <7) and documented management of shoulder dystocia (resolution manoeuvres performed, traction applied, head‐to‐body delivery interval). Results Compliance with national guidance improved with continued training. At least one recognised resolution manoeuvre was used in 99.8% (561/562) of cases of shoulder dystocia in the late training period, demonstrating a continued improvement from 46.3% (150/324, P < 0.001) pre‐training, and 92% (241/262, P < 0.001) in the early training period. In parallel there was reduction in the brachial plexus injury at birth (24/324 [7.4%, P < 0.01], pre‐training, 6/262 [2.3%] early training, and 7/562 [1.3%] late training. Conclusions There are significant benefits to long‐term, embedded training programmes with improvements in both management and outcomes. A decade after the introduction of training there were no cases of brachial plexus injury lasting over 12 months in 562 cases of shoulder dystocia.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Wiley
ISSN:	1470-0328
Date of Acceptance:	11 December 2014
Last Modified:	07 Nov 2022 10:43
URI:	https://orca.cardiff.ac.uk/id/eprint/133350

Citation Data

Cited 92 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item