Managing shoulder dystocia: perceptions of accoucheurs regarding their training

ABSTRACT

To assess the perceptions of labour ward staff at teaching hospitals regarding their theoretical and practical training for the management of shoulder dystocia as well as their opinion for further need of such trainings. Across sectional survey. At Islamic International Medical College, Railway Hospital Rawalpindi and College of Physicians and Surgeons Regional Centre Islamabad, from October to November 2008. The study was carried out by using a six item questionnaire. Four items were related to the respondent's training regarding the management of shoulder dystocia while two wete about their response to frequently performed actions which are known to increase the incidence of complications associated with the management of shoulder dystocia. Among sixty seven healthy personnel's involved in the management of parturient in the labour ward, 86.6% [n=58] were doctors and 1 3.4% [n=9] were midwives. The years of experience managing labouring patients ranged from 1 to 30 years. Although only 1 8% [n=1 2] thought that they did not have any theoretical training in shoulder dystocia and 40% [n=27] thought that they did not have any practical training, almost 72% [n=48] expressed a need for more theoretical and 91% [n=61] wanted more simulated training to manage shoulder dystocia. However, only 7.5% [n=5] of respondents involved in this survey said they would use fundal pressure and 1 0.4% [n=7] would apply strong traction to the fetal neck. In the opinion of labour ward attending physicians, the current level of their training for the management of shoulder dystocia is inadequate and there is a need for organizing regular practical training programs to improve their skills in managing this obstetric emergency