{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:33:12Z","timestamp":1792085592713,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the impact of shoulder dystocia (SD) simulation training on the management of SD and the incidence of permanent brachial plexus birth injury (BPBI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Helsinki University Women\u2019s Hospital, Finland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Deliveries with SD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multi\u2010professional, regular and systematic simulation training for obstetric emergencies began in 2015, and SD was one of the main themes. A study was conducted to assess changes in SD management and the incidence of permanent BPBI. The study period was from 2010 to 2019; years 2010\u20132014 were considered the pre\u2010training period and years 2015\u20132019 were considered the post\u2010training period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome measure was the incidence of permanent BPBI after the implementation of systematic simulation training. Changes in the management of SD were also analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 113\u2009085 vertex deliveries were recorded. The incidence of major SD risk factors (gestational diabetes, induction of labour, vacuum extraction) increased and was significantly higher for each of these factors during the post\u2010training period (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The incidence of SD also increased significantly (0.01% vs 0.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) during the study period, but the number of children with permanent BPBI decreased by 55% after the implementation of systematic simulation training (0.05% vs 0.02%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The most significant change in the management of SD was the increased incidence of successful delivery of the posterior arm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Systematic simulation\u2010based training of midwives and doctors can translate into improved individual and team performance and can significantly reduce the incidence of permanent BPBI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17278","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T12:39:06Z","timestamp":1660135146000},"page":"70-77","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury: An observational study"],"prefix":"10.1111","volume":"130","author":[{"given":"Marja","family":"Kaijomaa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2180-1483","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Academic Primary Health Care Centre \u2013 Region Stockholm  Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Outi","family":"\u00c4yr\u00e4s","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assi","family":"Sten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Grahn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology New Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00853"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2004.tb00463.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.79.2.0197"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2004.tb00455.x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0374-0"},{"issue":"3","key":"e_1_2_12_7_1","first-page":"35","article-title":"Shoulder dystocia: an evidence\u2010based approach","volume":"4","author":"Politi S","year":"2010","journal-title":"J Prenat Med"},{"key":"e_1_2_12_8_1","unstructured":"American College of Obstetricians and Gynecologists.Shoulder dystocia. ACOG Practice Pattern No. 40. Washington DC: ACOG;2002."},{"key":"e_1_2_12_9_1","unstructured":"Royal College of Obstetricians and Gynecologists.Shoulder dystocia. Guideline No. 42. London UK: RCOG;2005."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.002"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14022"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12952"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000183595.32077.83"},{"key":"e_1_2_12_14_1","unstructured":"Perinataalitilasto: synnytt\u00e4j\u00e4t synnytykset ja vastasyntyneet 2019: Raskauden aikainen tupakointi v\u00e4hentynyt[cited 2022 June 13]. Available from:https:\/\/www.thl.fi\/tilastoliite\/tilastoraportit\/2021\/Liitetaulukot\/Perinataalitilasto_2020_ennakko.pdf https:\/\/thl.fi\/en\/web\/thlfi\u2010en\/statistics\/statistics\u2010by\u2010topic\/sexual\u2010and\u2010reproductive\u2010health\/parturients\u2010deliveries\u2010and\u2010births\/perinatal\u2010statistics\u2010parturients\u2010delivers\u2010and\u2010newborns. 20.11.2020. Updated 23.9.2021."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000287615.35425.5c"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13302"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003606"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.052"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610801913145"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31824be910"},{"key":"e_1_2_12_21_1","volume-title":"To err is human: building a safer health system","author":"Institute of Medicine","year":"2000"},{"issue":"1","key":"e_1_2_12_22_1","first-page":"1","article-title":"Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006\u20132008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom","volume":"118","author":"Cantwell R","year":"2011","journal-title":"BJOG"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000231"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.06.023"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817bbc61"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126816.98387.1c"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.05.008"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002682"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-2001-0"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181865f55"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818c177b"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000286779.41037.38"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340903176834"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JPN.0000319097.05415.1d"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.008"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.003"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.04.007"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70034-6"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adnc.2005.03.004"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318264f644"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.06.004"},{"key":"e_1_2_12_42_1","first-page":"ix","article-title":"Summary of substandard care in cases of brachial plexus injury","author":"NHS Litigation Authority","year":"2003","journal-title":"NHSLA J"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.01.027"},{"key":"e_1_2_12_44_1","unstructured":"World Health Organization.Patient safety curriculum guide[cited 2022 Mar 2]. Multi\u2010professional edition. 6.7.2011. World Health Organization.https:\/\/who.int\/publications\/i\/item9789241501958"},{"key":"e_1_2_12_45_1","unstructured":"American College of Obstetricians and Gynecologists.Emergencies in Clinical Obstetrics (ECO). Version 3[cited 2022 Aug 15].https:\/\/www.acog.org\/education\u2010and\u2010events\/simulations\/eco"},{"key":"e_1_2_12_46_1","unstructured":"JCAHO.Preventing infant death and injury: sentinel event alert #30 2004[cited 2022 Mar 2]. The Joint Commission. Sentinel Event Alert.https:\/\/jointcomission.org\/\u2010\/media\/tjc\/documents\/resources\/patient\u2010safety\u2010topics\/sentinel\u2010event\/sea 30.pdf"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adnc.2004.08.005"},{"key":"e_1_2_12_48_1","unstructured":"Raskana olevien ja synnytt\u00e4jien h\u00e4t\u00e4tilanteiden hoito.Suomen synnytyssairaaloiden yhten\u00e4inen koulutusohjelma[cited 2022 Mar 2].https:\/\/www.perinatologinenseura.fi\/simulaatiojaos\/raskaana\u2010olevien\u2010ja\u2010synnyttajien\/"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249031"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.17278","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T15:23:24Z","timestamp":1692545004000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.17278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,2]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/1471-0528.17278"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.17278","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,2]]},"assertion":[{"value":"2022-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}