Shoulder Dystocia Training Improves Neonatal Outcomes

Training leads to better clinical management and reduced rate of neonatal injury at birth

MONDAY, July 14 (HealthDay News) -- The introduction of shoulder dystocia training for all hospital maternity staff can significantly improve management of the complication as well as neonatal outcomes, according to research published in the July issue of Obstetrics & Gynecology.

Timothy J. Draycott, M.D., of Southmead Hospital in Bristol, U.K., and colleagues compared the management and neonatal outcome of births complicated by shoulder dystocia before the introduction of shoulder dystocia training (January 1996-December 1999) and afterward (January 2001-December 2004).

The researchers found that clinical management improved post-training and observed increases in such maneuvers as McRoberts' position (29.3 percent pre-training to 87.4 percent post-training), suprapubic pressure (27.8 percent pre-training to 45.4 percent post-training), internal rotation (6.8 percent pre-training to 11.1 percent post-training) and delivery of posterior arm (7.4 percent pre-training to 19.8 percent post-training). They also observed a significant reduction in neonatal injury at birth after shoulder dystocia (9.3 percent versus 2.3 percent).

"Shoulder dystocia is largely unpredictable and unpreventable," the authors write. "Therefore, practical training of all staff may be the single most effective method of optimizing neonatal outcomes after this difficult and potentially dangerous obstetric complication."

Draycott has been a consultant to Limbs and Things Ltd (Bristol, U.K.), manufacturers of the PROMPT Birthing Simulator.

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