A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries.
Aust N Z J Obstet Gynaecol
; 60(5): 704-708, 2020 10.
Article
in En
| MEDLINE
| ID: mdl-32067227
ABSTRACT
BACKGROUND:
Following the Term Breech Trial, vaginal breech deliveries are rarely undertaken in Australia. Some women choose to have a breech delivery following counselling, while others will present in labour with an undiagnosed breech. Clinicians need to be skilled in vaginal breech delivery despite this being a rare clinical situation. Simulation training provides a means by which uncommon clinical situations can be practised.AIM:
This study aims to determine if the introduction of a simulation-based training course is associated with an improvement in the management of vaginal breech delivery and neonatal outcomes.METHODS:
Cases of term vaginal breech delivery five years prior to introduction of In Time training (2001-2005) and five years after In Time training (2007-2011) were identified in a tertiary obstetric hospital (King Edward Memorial Hospital, Perth). There were 136 women identified in the pre-training (2001-2005, n = 56) and post-training (2007-2011, n = 80) groups. Case note review was undertaken to gather information.RESULTS:
Apgar scores of <7 at five minutes were higher in the post-training cohort (8.8% vs 0%, P = 0.041). Arterial and venous pH readings were similar between cohorts, with a non-significant trend toward improvement in the post-training cohort. Special care nursery admissions and length of hospital stay were unchanged. The primary accoucheur was more likely to be a consultant (35.0% vs 16.4%) in the post-training cohort. Appropriate manoeuvres were more likely to be used in the post-training cohort (52.5% vs 44.6%).CONCLUSIONS:
Obstetric In Time simulation training improved seniority of accoucheur and documented appropriate manoeuvres in the management of term vaginal breech delivery.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Breech Presentation
/
Simulation Training
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Newborn
/
Pregnancy
Country/Region as subject:
Oceania
Language:
En
Journal:
Aust N Z J Obstet Gynaecol
Year:
2020
Type:
Article
Affiliation country:
Australia