Severe Postpartum Femoral Neuropathy: A Case Series.

BACKGROUND: Femoral neuropathy is a rare complication of vaginal delivery that is often under-reported. It is marked by weakness and sensory loss in the lower limbs. This report presents 3 cases to outline possible prevention strategies, as well as to describe the process of diagnosis, management, and recovery for this injury. CASES: Diagnosis is made clinically, and prognosis is determined by clinical follow-up along with nerve conduction studies and electromyography. Management involves interdisciplinary efforts with physiotherapy. Prevention includes frequent repositioning and avoidance of hip hyperflexion during labour. The expected recovery period ranges from 2 to 24 months. CONCLUSION: Femoral neuropathy after vaginal delivery is under-reported. Though prognosis is often excellent, special attention to positioning during labour, prompt clinical diagnosis, and interdisciplinary management are essential for this rare injury.

Impact of a Multidimensional Technical Skills Training Session Before Obstetrics and Gynaecology Clerkship Rotation on Performance and Exposure.

OBJECTIVE: This study sought to assess the impact of an obstetrics and gynaecology (OBGYN) multidimensional technical skills training session on medical student self-perceived confidence, objective performance, clinical exposure, and interest in OBGYN. METHODS: OBGYN clerkship students were divided into control (i.e., traditional curriculum) and intervention (i.e., additional pre-rotation simulation training in vaginal delivery, suturing and knot tying, speculum and bimanual examinations, and intrapartum cervical examination) groups. Both groups underwent an objective structured clinical examination (OSCE) after the rotation and completed pre- and post-rotation questionnaires to assess confidence, clinical exposure, and interest in OBGYN. The primary outcomes were self-reported confidence and OSCE scores, and the secondary outcomes were clinical exposure and interest in OBGYN. RESULTS: A total of 148 students participated. Both groups reported least confidence with vaginal delivery and cervical examinations before the rotation. There was improved self-confidence across all skills after the rotation, with the intervention group demonstrating greater improvement for vaginal delivery (3.36 vs. 3.10; P < 0.05) and cervical examination (3.14 vs. 2.86; P < 0.05). The intervention group also demonstrated a trend towards higher OSCE scores for all skills, but only speculum and bimanual examinations reached statistical significance. The intervention increased exposure from "0 to 5" to "6 to 10" for vaginal delivery and suturing. There was no difference in interest in OBGYN between the two groups. CONCLUSION: A technical skills training session before OBGYN clerkship is feasible and has the potential to increase students' confidence, OSCE performance, and hands-on procedural exposure. The optimal combination of skills to be included still needs to be defined.