A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries

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 despit...

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Veröffentlicht in:Australian & New Zealand journal of obstetrics & gynaecology 2020-10, Vol.60 (5), p.704-708
Hauptverfasser: Hardy, Liesel, Garratt, Jayna‐Lee, Crossley, Brendan, Copson, Sean, Nathan, Elizabeth, Calvert, Katrina, Epee‐Bekima, Mathias
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container_end_page 708
container_issue 5
container_start_page 704
container_title Australian & New Zealand journal of obstetrics & gynaecology
container_volume 60
creator Hardy, Liesel
Garratt, Jayna‐Lee
Crossley, Brendan
Copson, Sean
Nathan, Elizabeth
Calvert, Katrina
Epee‐Bekima, Mathias
description 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
doi_str_mv 10.1111/ajo.13132
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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 &lt;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.</description><identifier>ISSN: 0004-8666</identifier><identifier>EISSN: 1479-828X</identifier><identifier>DOI: 10.1111/ajo.13132</identifier><identifier>PMID: 32067227</identifier><language>eng</language><publisher>Australia</publisher><subject>Australia ; breech delivery ; Breech Presentation - therapy ; Delivery, Obstetric ; Female ; Humans ; Infant, Newborn ; perinatal outcome ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Simulation Training ; training</subject><ispartof>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology, 2020-10, Vol.60 (5), p.704-708</ispartof><rights>2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists</rights><rights>2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3252-9609ff3fbdefd2b5830ad235d073e2cb4236843b403f7812835380cd7308e0a33</citedby><cites>FETCH-LOGICAL-c3252-9609ff3fbdefd2b5830ad235d073e2cb4236843b403f7812835380cd7308e0a33</cites><orcidid>0000-0003-2329-7663</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajo.13132$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajo.13132$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32067227$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hardy, Liesel</creatorcontrib><creatorcontrib>Garratt, Jayna‐Lee</creatorcontrib><creatorcontrib>Crossley, Brendan</creatorcontrib><creatorcontrib>Copson, Sean</creatorcontrib><creatorcontrib>Nathan, Elizabeth</creatorcontrib><creatorcontrib>Calvert, Katrina</creatorcontrib><creatorcontrib>Epee‐Bekima, Mathias</creatorcontrib><title>A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries</title><title>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology</title><addtitle>Aust N Z J Obstet Gynaecol</addtitle><description>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 &lt;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.</description><subject>Australia</subject><subject>breech delivery</subject><subject>Breech Presentation - therapy</subject><subject>Delivery, Obstetric</subject><subject>Female</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>perinatal outcome</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Simulation Training</subject><subject>training</subject><issn>0004-8666</issn><issn>1479-828X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOwzAUQC0EgvIY-AHkEYa0fuThjFXFU0hdQGKLHOemNYrjYjtFXfh2DAE2vNiWzj1XOgidUzKl8czkq51STjnbQxOaFmUimHjZRxNCSJqIPM-P0LH3r4TQMqPpITrijOQFY8UEfcyxg-Cs34AKegtY2bV1AfswNDtsWxzWgLXZSBW-fvc9ftIGsK19iGNaYa_N0MmgbY-Dk7rX_QrHt5G9XIGB_ntsK1e6lx2uHYBa4wa6uMpp8KfooJWdh7Of-wQ931w_Le6Sx-Xt_WL-mCjOMpaUOSnblrd1A23D6kxwIhvGs4YUHJiqU8ZzkfI6JbwtBGWCZ1wQ1RScCCCS8xN0OXo3zr4N4ENltFfQdbIHO_gquoo0K9Myi-jViKpYxTtoq43TRrpdRUn1lbuKuavv3JG9-NEOtYHmj_ztG4HZCLzrDnb_m6r5w3JUfgITEYqp</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Hardy, Liesel</creator><creator>Garratt, Jayna‐Lee</creator><creator>Crossley, Brendan</creator><creator>Copson, Sean</creator><creator>Nathan, Elizabeth</creator><creator>Calvert, Katrina</creator><creator>Epee‐Bekima, Mathias</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2329-7663</orcidid></search><sort><creationdate>202010</creationdate><title>A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries</title><author>Hardy, Liesel ; Garratt, Jayna‐Lee ; Crossley, Brendan ; Copson, Sean ; Nathan, Elizabeth ; Calvert, Katrina ; Epee‐Bekima, Mathias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3252-9609ff3fbdefd2b5830ad235d073e2cb4236843b403f7812835380cd7308e0a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Australia</topic><topic>breech delivery</topic><topic>Breech Presentation - therapy</topic><topic>Delivery, Obstetric</topic><topic>Female</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>perinatal outcome</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Simulation Training</topic><topic>training</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hardy, Liesel</creatorcontrib><creatorcontrib>Garratt, Jayna‐Lee</creatorcontrib><creatorcontrib>Crossley, Brendan</creatorcontrib><creatorcontrib>Copson, Sean</creatorcontrib><creatorcontrib>Nathan, Elizabeth</creatorcontrib><creatorcontrib>Calvert, Katrina</creatorcontrib><creatorcontrib>Epee‐Bekima, Mathias</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hardy, Liesel</au><au>Garratt, Jayna‐Lee</au><au>Crossley, Brendan</au><au>Copson, Sean</au><au>Nathan, Elizabeth</au><au>Calvert, Katrina</au><au>Epee‐Bekima, Mathias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries</atitle><jtitle>Australian &amp; New Zealand journal of obstetrics &amp; gynaecology</jtitle><addtitle>Aust N Z J Obstet Gynaecol</addtitle><date>2020-10</date><risdate>2020</risdate><volume>60</volume><issue>5</issue><spage>704</spage><epage>708</epage><pages>704-708</pages><issn>0004-8666</issn><eissn>1479-828X</eissn><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 &lt;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.</abstract><cop>Australia</cop><pmid>32067227</pmid><doi>10.1111/ajo.13132</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-2329-7663</orcidid></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Australia
breech delivery
Breech Presentation - therapy
Delivery, Obstetric
Female
Humans
Infant, Newborn
perinatal outcome
Pregnancy
Pregnancy Outcome
Retrospective Studies
Simulation Training
training
title A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries
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