Document Detail


Does training in obstetric emergencies improve neonatal outcome?
MedLine Citation:
PMID:  16411995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether the introduction of Obstetrics Emergency Training in line with the recommendations of the Clinical Negligence Scheme for Trusts (CNST) was associated with a reduction in perinatal asphyxia and neonatal hypoxic-ischaemic encephalopathy (HIE). DESIGN: A retrospective cohort observational study. SETTING: A tertiary referral maternity unit in a teaching hospital. POPULATION: Term, cephalic presenting, singleton infants born at Southmead Hospital between 1998 and 2003 were identified; those born by elective Caesarean sections were excluded. METHOD: Five-minute Apgar scores were reviewed. Infants that developed HIE were prospectively identified throughout this period. The study compared the period 'pre-training' (1998-1999), with the period 'post-training' (2001-2003). MAIN OUTCOME MEASURES: Five-minute Apgar scores and HIE. RESULTS: Infants (19,460) were included. Infants born with 5-minute Apgar scores of <or=6 decreased from 86.6 to 44.6 per 10,000 births (P<0.001) and those with HIE decreased from 27.3 to 13.6 per 10,000 births (P=0.032) following the introduction of the training courses in 2000. Antepartum and intrapartum stillbirth at term rates remained unchanged, at about 15 and 4 per 10,000 births, respectively. CONCLUSION: The introduction of obstetric emergencies training courses was associated with a significant reduction in low 5-minute Apgar scores and HIE. This improvement has been sustained as the training has continued. This is the first time an educational intervention has been shown to be associated with a clinically important, and sustained, improvement in perinatal outcome.
Authors:
Tim Draycott; Thabani Sibanda; Louise Owen; Valentine Akande; Cathy Winter; Sandra Reading; Andrew Whitelaw
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  113     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-17     Completed Date:  2006-04-04     Revised Date:  2006-09-14    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  AIM; IM    
Affiliation:
Women's and Children's Directorate, Southmead Hospital, and Department of Clinical Science at North Bristol, University of Bristol, UK.
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MeSH Terms
Descriptor/Qualifier:
Apgar Score
Asphyxia Neonatorum / prevention & control*
Cohort Studies
Emergency Medicine / education*
Female
Fetal Death
Humans
Hypoxia-Ischemia, Brain / prevention & control*
Infant, Newborn
Obstetrics / education*
Pregnancy
Pregnancy Outcome
Prospective Studies
Retrospective Studies
Stillbirth
Comments/Corrections
Comment In:
BJOG. 2006 Aug;113(8):980   [PMID:  16907953 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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