The incidence of shoulder
dystocia nationally among
is 0.2-3%. At the University of Oklahoma, 70 out of 3781 vaginal
dystocia (1%). Shoulder dystocias are associated with significant morbidity and
to the mother or baby. They are associated with postpartum hemorrhage
and a higher degree of perineal lacerations
injuries include brachial plexus injuries and clavicular or humeral fractures.
At OU, 29% infants
that experience shoulder dystocia
neonatal injury. This exceeds the NPIC benchmark of 15%. Additionally, documentation is important to
guide counseling on future risks and inform other healthcare providers.
Current practice at OU does not involve a standardized
flow and physician/
nursing documentation often differs. From April to November 2021, physician and nursing documentation only aligned 32% of
Discrepancies include order of maneuvers, timing of
interventions or both
We hypothesized that if there is a standardized process for executing a
shoulder dystocia and debriefing thereafter, then the rate of injury will
decrease and the rate of discrepancy in documentation will also decrease.
The goal of the simulations was to increase preparation in the delivery room for
those at increased risk of shoulder dystocia, educate participants
dystocia maneuvers and
, and implement clear and concise communication amongst team members.