Key result
Following a simulation-based training program, obstetric brachial plexus palsy occurred in 11.2% of shoulder dystocia cases, with no permanent injuries compared to 2 permanent cases before training.
Why the study?
Shoulder dystocia is an unpredictable obstetric emergency causing severe complications, and the impact of simulation-based training on the incidence of obstetric brachial plexus palsy and neonatal complications needed evaluation.
Does simulation-based training for shoulder dystocia reduce the incidence and severity of obstetric brachial plexus palsy?
Observational (n=125)
No
Does simulation-based training for shoulder dystocia reduce the incidence and severity of obstetric brachial plexus palsy?
Simulation-based training for shoulder dystocia may reduce the severity and permanence of obstetric brachial plexus palsy.
Simulation training was associated with no permanent brachial plexus injuries; hypothesis-generating and requires randomized confirmation before practice change.
Shoulder dystocia is a nonpreventable obstetric emergency that causes severe complications, such as obstetric brachial plexus palsy. The objective of the study was to determine the incidence of obstetric brachial plexus palsy and other neonatal complications associated with shoulder dystocia in deliveries managed in a university hospital after the implementation of a simulation-based training that was offered to all the labour and delivery staff on a voluntary basis.Retrospective observational study including all cases of shoulder dystocia and associated complications (mainly obstetric brachial plexus palsy) documented between January 2017 and December 2020, after the implementation of the training. In addition, we collected retrospective data on cases of obstetric brachial plexus palsy that developed in the hospital before the training (2008-2016).In the 2017-2020 period, in the total of 125 cases of shoulder dystocia (amounting to 1.38% of vaginal deliveries), there were 14 cases of obstetric brachial plexus palsy (11.2% of the cases of shoulder dystocia), 7 clavicle fractures and 1 humerus fracture; none of the cases of obstetric brachial plexus palsy was permanent or required treatment or rehabilitation past six months. In the years preceding the training, there were 7 cases of obstetric brachial plexus palsy, 2 permanent and 5 temporary (3 of which required rehabilitation).These results reflect the importance of knowing the morbidity present in the labour and delivery ward and the potential benefit of simulation-based training programmes in the resolution of these obstetric complications.
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López et al. (2022) conducted an observational in Shoulder dystocia (n=125). Simulation-based training program vs. Before training (2008-2016) was evaluated on Incidence of obstetric brachial plexus palsy. Following a simulation-based training program, obstetric brachial plexus palsy occurred in 11.2% of shoulder dystocia cases, with no permanent injuries compared to 2 permanent cases before training.
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