{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:56:07Z","timestamp":1791503767066,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"vor","delay-in-days":33,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obstetrics and Gynecology International"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. To test the hypothesis that PROMPT reduces permanent brachial plexus palsy and perineal tears. <jats:italic>Design<\/jats:italic>. A prospective\/retrospective cohort study. <jats:italic>Setting<\/jats:italic>. Hanover Medical School, Germany. <jats:italic>Population\/Sample<\/jats:italic>. A self\u2010selected population. <jats:italic>Methods<\/jats:italic>. The training period is from November 9<jats:sup>th<\/jats:sup>, 2017, until December 31<jats:sup>st<\/jats:sup>, 2019; control: January 1<jats:sup>st<\/jats:sup>, 2004, until November 8<jats:sup>th<\/jats:sup>, 2017. <jats:italic>Main Outcome Measures<\/jats:italic>. Shoulder dystocia, nonpermanent and permanent brachial plexus injuries (BPIs), perineal tears III\u00b0\/IV\u00b0, manual manoeuvres, and asphyxia. <jats:italic>Results<\/jats:italic>. There was a total of 22,640 births, and shoulder dystocia increased from 48\/18,031 (0.27%) to 23\/4,609 (0.50%) ((<jats:italic>p<\/jats:italic> = 0.017), OR: 1.88, 95% CI: (1.14; 3.09)), whereas BPIs decreased from 7\/48 (14.6%) to 1\/23 (4.3%) (<jats:italic>p<\/jats:italic> = 0.261). There was 1\/7 (14.2%) of permanent BPI before and 0\/1 (0%) case after. Perinatal asphyxia increased from 3\/48 (6.3%) to 4\/23 (17.4%) (<jats:italic>p<\/jats:italic> = 0.23). However, adverse outcomes after one year were zero. McRoberts\u2019 manoeuvre increased from 37\/48 (77.1%) to 23\/23 (100%) ((<jats:italic>p<\/jats:italic> = 0.013), OR: 1.62, 95% CI: (1.33; 1.98)), and internal rotation manoeuvres and manual extraction of the posterior arm from 6\/48 (12.5%) to 5\/23 (21.7%) (<jats:italic>p<\/jats:italic> = 0.319). Episiotomies decreased from 5,267\/18,031 (29.2%) to 836\/4,609 (18.1%) ((<jats:italic>p<\/jats:italic> &lt; 0.001), OR: 0.54, 95% CI: (0.49, 0.58)), whereas perineal tears III\u00b0\/IV\u00b0 associated with shoulder dystocia increased from 1\/48 (2.1%) to 1\/23 (4.8%) (<jats:italic>p<\/jats:italic> = 0.546). Vaginal operative deliveries remained constant (6.5% vs. 7%). <jats:italic>Conclusions<\/jats:italic>. PROMPT significantly improves the management of shoulder dystocia and decreases permanent brachial plexus injuries but not perineal tears III\u00b0\/IV\u00b0.<\/jats:p>","DOI":"10.1155\/2024\/8712553","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T16:35:11Z","timestamp":1706978111000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Introducing PROMPT on Permanent Brachial Plexus Injury and Tears III\u00b0\/IV\u00b0 in Shoulder Dystocia: The Hanover Cohort Study"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3595-1398","authenticated-orcid":false,"given":"Spyridon","family":"Papageorgiou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1155-4781","authenticated-orcid":false,"given":"Lars","family":"Brodowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halina","family":"Huppertz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Bohnhorst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-8998","authenticated-orcid":false,"given":"Markus","family":"Flentje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5554-1937","authenticated-orcid":false,"given":"Constantin","family":"von Kaisenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,3]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S175088"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(05)70080-2"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001447"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-2001-0"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13302"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.12.042"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2863-x"},{"key":"e_1_2_12_8_2","volume-title":"Shoulder Dystocia","author":"Davis D. 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