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- W2079656718 abstract "To determine the effect of demonstrative instruction on performance in managing simulated shoulder dystocia (SD) using objective metrics. Using a patented, biofidelic birthing simulator, we simulated SD in ROA presentation. 8 OB/GYN interns each performed simulated SD deliveries twice, before and after instruction in SD maneuvers focusing on posterior arm delivery. For each delivery, we continuously measured traction, neck extension, anterior and posterior brachial plexus (BP) strain, head twist, head tilt, and head-to-body time interval (HTB), selecting peak values for analysis with Student t-test. p<0.05 was considered significant. None of the interns initially recognized shoulder dystocia. The results of mean peak values are given in the table. After demonstrative instruction, traction decreased significantly by 63.7% as did neck extension by 62.6%. Anterior BP strain decreased significantly by 32.6% and posterior BP strain by 19.8%. A trend towards increased mean HTB time interval (from 58.4 seconds to 119.5 seconds) was also noted after instruction.Tabled 1Table of ResultsBefore InstructionAfter InstructionP-ValueTraction (lbs)20.1±8.67.3±4.30.007Extension (mm)9.1±2.43.4±1.6<0.001Anterior BP Strain (%)26.1±4.717.6±4.70.008Posterior BP Strain (%)16.2±2.513.0±3.00.04Head-to-Body Interval (seconds)58.4±30.0119.5±112.10.1 Open table in a new tab Demonstrative instruction in SD maneuvers increases SD awareness and significantly reduces clinician-applied traction, neck extension, and brachial plexus strain. Feedback from biofidelic simulation may ultimately lead to reduction in SD injuries." @default.
- W2079656718 created "2016-06-24" @default.
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- W2079656718 date "2009-12-01" @default.
- W2079656718 modified "2023-10-16" @default.
- W2079656718 title "539: Demonstrative shoulder dystocia instruction leads to reduced traction, neck extension, and brachial plexus stretch in simulated deliveries" @default.
- W2079656718 doi "https://doi.org/10.1016/j.ajog.2009.10.404" @default.
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