title: Effects of shoulder dystocia training on the incidence of brachial plexus injury.
abstract: OBJECTIVE
  We sought to determine whether implementation of shoulder dystocia training reduces the incidence of obstetric brachial plexus injury (OBPI).
  
  
  METHODS
  After implementing training for maternity staff, the incidence of OBPI was compared between pretraining and posttraining periods using both univariate and multivariate analyses in deliveries complicated by shoulder dystocia.
  
  
  RESULTS
  The overall incidence of OBPI in vaginal deliveries decreased from 0.40% pretraining to 0.14% posttraining (P < .01). OBPI after shoulder dystocia dropped from 30% to 10.67% posttraining (P < .01). Maternal body mass index (P < .01) and neonatal weight (P = .02) decreased and head-to-body delivery interval increased in the posttraining period (P = .03). Only shoulder dystocia training remained associated with reduced OBPI (P = .02) after logistic regression analysis. OBPI remained less in the posttraining period (P = .01), even after excluding all neonates with birthweights >2 SD above the mean.
  
  
  CONCLUSIONS
  Shoulder dystocia training was associated with a lower incidence of OBPI and the incidence of OBPI in births complicated by shoulder dystocia.
authors.affiliation: Department of Obstetrics and Gynecology, Jamaica Hospital Medical Center, Jamaica, NY 11418, USA. singlis@jhmc.org
authors.forename: Steven R
authors.initials: SR
authors.lastname: Inglis
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Feier
authors.forename: Jyothi B
authors.initials: JB
authors.lastname: Chetiyaar
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Naylor
authors.forename: Melanie
authors.initials: M
authors.lastname: Sumersille
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Cervellione
authors.forename: Mladen
authors.initials: M
authors.lastname: Predanic
mesh_terms: D001720:Birth Injuries / Q000517:prevention & control*; D001724:Birth Weight; D015992:Body Mass Index; D001917:Brachial Plexus / Q000293:injuries*; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods; D004420:Dystocia; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007318:Inservice Training; D016015:Logistic Models; D011247:Pregnancy; D012189:Retrospective Studies; D012782:Shoulder