Effects of shoulder dystocia training on the incidence of brachial plexus injury

Objective We sought to determine whether implementation of shoulder dystocia training reduces the incidence of obstetric brachial plexus injury (OBPI). Study Design After implementing training for maternity staff, the incidence of OBPI was compared between pretraining and posttraining periods using...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2011-04, Vol.204 (4), p.322.e1-322.e6
Main Authors: Inglis, Steven R., MD, Feier, Nikolaus, MD, Chetiyaar, Jyothi B., MD, Naylor, Margaret H., CNM, Sumersille, Melanie, CNM, Cervellione, Kelly L., MA, Predanic, Mladen, MD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Birth Injuries - prevention & control
Birth Weight
Body Mass Index
Brachial Plexus - injuries
Cesarean Section - statistics & numerical data
Cohort Studies
Delivery, Obstetric - education
Delivery, Obstetric - methods
Delivery. Postpartum. Lactation
Diseases of mother, fetus and pregnancy
Disorders
Dystocia
Erb's palsy
Female
Gynecology. Andrology. Obstetrics
Humans
Incidence
Infant, Newborn
Inservice Training
Logistic Models
Medical sciences
obstetric brachial plexus injury
Obstetrics and Gynecology
Pregnancy
Pregnancy. Fetus. Placenta
Retrospective Studies
Shoulder
shoulder dystocia
shoulder dystocia training
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Summary:Objective We sought to determine whether implementation of shoulder dystocia training reduces the incidence of obstetric brachial plexus injury (OBPI). Study Design After implementing training for maternity staff, the incidence of OBPI was compared between pretraining and posttraining periods using both univariate and multivariate analyses in deliveries complicated by shoulder dystocia. Results The overall incidence of OBPI in vaginal deliveries decreased from 0.40% pretraining to 0.14% posttraining ( P < .01). OBPI after shoulder dystocia dropped from 30% to 10.67% posttraining ( P < .01). Maternal body mass index ( P < .01) and neonatal weight ( P = .02) decreased and head-to-body delivery interval increased in the posttraining period ( P = .03). Only shoulder dystocia training remained associated with reduced OBPI ( P = .02) after logistic regression analysis. OBPI remained less in the posttraining period ( P = .01), even after excluding all neonates with birthweights >2 SD above the mean. Conclusion Shoulder dystocia training was associated with a lower incidence of OBPI and the incidence of OBPI in births complicated by shoulder dystocia.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2011.01.027