title: Outcomes associated with introduction of a shoulder dystocia protocol.
abstract: The objective of this study was to assess outcomes that are associated with the implementation of a shoulder dystocia protocol that is focused on team response. We identified women who had a shoulder dystocia during 3 time periods: 6 months before (period A), 6 months during (period B), and 6 months after (period C) the institution of a shoulder dystocia protocol. Documentation and health outcomes were compared among the time periods. During the study period, 254 women (77, 100, and 77 in periods A, B, and C, respectively) had a shoulder dystocia. There were no differences among study periods in patient characteristics. However, complete and consistent documentation increased (14% to 50% to 92%; P < .001), and brachial plexus palsy that was diagnosed at delivery (10.1% to 4.0% to 2.6%; P = .03) and at neonatal discharge (7.6% to 3.0% to 1.3%; P = .04) declined.
authors.affiliation: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern Medical School, Chicago, IL, USA. w-grobman@northwestern.edu
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.forename: Deborah
authors.initials: D
authors.lastname: Miller
authors.forename: Carol
authors.initials: C
authors.lastname: Burke
authors.forename: Abby
authors.initials: A
authors.lastname: Hornbogen
authors.forename: Karen
authors.initials: K
authors.lastname: Tam
authors.forename: Robert
authors.initials: R
authors.lastname: Costello
mesh_terms: D001720:Birth Injuries / Q000517:prevention & control; D004420:Dystocia / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D005113:Extraction, Obstetrical / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010246:Paralysis, Obstetric / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D012782:Shoulder