{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:08:54Z","timestamp":1792796934454,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T00:00:00Z","timestamp":1424131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006662","name":"National Institute on Handicapped Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate management and outcomes of incidences of shoulder dystocia in the 12\u00a0years following the introduction of an obstetric emergencies training programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Interrupted time\u2010series study comparing management and neonatal outcome of births complicated by shoulder dystocia over three 4\u2010year periods: (i) Pre\u2010training (1996\u201399), (ii) Early training (2001\u201304), and (iii) Late training (2009\u201312).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Southmead Hospital, Bristol, UK, with approximately 6000 births per annum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Infants and their mothers who experienced shoulder dystocia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A bi\u2010monthly multi\u2010professional 1\u2010day intrapartum emergencies training course, that included a 30\u2010minute practical session on shoulder dystocia management, commenced in 2000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes<\/jats:title><jats:p>Neonatal morbidity (brachial plexus injury, humeral fracture, clavicular fracture, 5\u2010minute Apgar score &lt;7) and documented management of shoulder dystocia (resolution manoeuvres performed, traction applied, head\u2010to\u2010body delivery interval).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compliance with national guidance improved with continued training. At least one recognised resolution manoeuvre was used in 99.8% (561\/562) of cases of shoulder dystocia in the late training period, demonstrating a continued improvement from 46.3% (150\/324, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) pre\u2010training, and 92% (241\/262, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) in the early training period. In parallel there was reduction in the brachial plexus injury at birth (24\/324 [7.4%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01], pre\u2010training, 6\/262 [2.3%] early training, and 7\/562 [1.3%] late training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are significant benefits to long\u2010term, embedded training programmes with improvements in both management and outcomes. A decade after the introduction of training there were no cases of brachial plexus injury lasting over 12\u00a0months in 562 cases of shoulder dystocia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13302","type":"journal-article","created":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T12:04:00Z","timestamp":1424174640000},"page":"111-118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":157,"title":["Prevention of brachial plexus injury\u201412\u00a0years of shoulder dystocia training: an interrupted time\u2010series study"],"prefix":"10.1111","volume":"123","author":[{"given":"JF","family":"Crofts","sequence":"first","affiliation":[{"name":"School of Social and Community Medicine University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Lenguerrand","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences University of Bristol Southmead Hospital Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GL","family":"Bentham","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust Southmead Hospital Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Tawfik","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust Southmead Hospital Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HA","family":"Claireaux","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Odd","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences University of Bristol Southmead Hospital Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Fox","sequence":"additional","affiliation":[{"name":"Taunton and Somerset NHS Trust Taunton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TJ","family":"Draycott","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90008-1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.054"},{"key":"e_1_2_6_4_1","volume-title":"Green top Guideline No. 42: Shoulder Dystocia","author":"Royal College Obstetricians and Gynaecologists","year":"2012"},{"key":"e_1_2_6_5_1","first-page":"1045","article-title":"ACOG practice bulletin clinical management guidelines for obstetrician\u2010gynecologists","volume":"100","author":"Amercian Congress of Obstetricians and Gynacologists","year":"2002","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70565-9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70312-6"},{"key":"e_1_2_6_8_1","first-page":"762","article-title":"Risk factors for shoulder dystocia","volume":"66","author":"Acker DB","year":"1985","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817bbc61"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.06.004"},{"key":"e_1_2_6_11_1","volume-title":"Ten Years of Maternity Claims: An Analysis of NHS Litigation Authority Data","author":"NHS Litigation Authority","year":"2012"},{"key":"e_1_2_6_12_1","first-page":"73","volume-title":"CESDI 5th Annual Report \u2013 Focus Group Shoulder Dystocia","author":"Maternal and Child Health Research Consortium","year":"1998"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01493.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340903176834"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/13561820500476473"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000246801.45977.c8"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00559.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126816.98387.1c"},{"key":"e_1_2_6_19_1","first-page":"322 e1\u20136","article-title":"Effects of shoulder dystocia training on the incidence of brachial plexus injury","volume":"204","author":"Inglis SR","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.05.002"},{"key":"e_1_2_6_21_1","first-page":"324 e1\u20136","article-title":"Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades","volume":"204","author":"Walsh JM","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000287615.35425.5c"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00800.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181865f55"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.03.038"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000286779.41037.38"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01801.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e318222fde9"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.08.043"},{"key":"e_1_2_6_30_1","volume-title":"Obstetric Skills Training","author":"Soerensen JL","year":"2007"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.13302","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.13302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T06:47:22Z","timestamp":1695538042000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.13302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,17]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.1111\/1471-0528.13302"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.13302","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,17]]},"assertion":[{"value":"2014-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}