Obstetric Emergencies: Role of Obstetric Drill for a Better Maternal Outcome

Abstract

Objective To evaluate factors contributing to obstetric emergencies, analyze the fetomaternal outcome and role of obstetric drill in facing these emergencies effectively. Material and Method Out of 10,892 deliveries, a total of 520 women were included in this prospective study. Analysis of emergency obstetric conditions was done by evaluating incidence, various contributing factors, and fetomaternal outcome. Obstetric drill was conducted among residents repetitively. Pre drill and post drill assessment of confidence in clinical, knowledge, and team work skills were compared by v 2 test. Impact of drill on severe obstetric morbidities was noted. Observations Incidence of obstetric emergencies was found to be 4.88 %. Maternal and perinatal mortality was seen in 4.23 and 37.11 %, respectively, of these emergency obstetric women. Impact of drill showed an increase in score in knowledge (p \ 0.019), confidence (p, 0.001), and team work (p \ 0.001). Conclusion Active implementation of emergency obstetric care and incorporation of obstetric drill lays a strong foundation for safe fetomaternal outcome.

Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study

“…Reports from studies that have evaluated training programs in India have emphasized the need for dedicated personnel and a trainee tracking system to ensure quality training management and implementation 9 , 17 . They have also showed that strengthening essential supplies and supportive supervision is critical to practice and to retain the newly acquired skills.…”

“…The assessment recommended improving clinical skills competencies and facility preparedness, especially emergency preparedness through a continuous support mechanism 5 . Recent studies on emergency preparedness have reported that emergency obstetric drills have resulted in improvements in the knowledge and skill levels of providers as well as in facility preparedness 6 – 9 …”

Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital

“…1 While most childbirth related complication allows time for proper management, a few present as obstetric emergencies where successful outcome depends on prompt action and systematic rapid management. [1][2][3][4] Obstetric emergencies are defined as situations of serious and often dangerous nature, developing suddenly and unexpectedly and demanding immediate attention in order to save life. [1][2][3][4] These emergencies are not only encountered in perinatal period as post-partum hemorrhage, ruptured uterus, retained placenta, etc.…”

“…[1][2][3][4] Obstetric emergencies are defined as situations of serious and often dangerous nature, developing suddenly and unexpectedly and demanding immediate attention in order to save life. [1][2][3][4] These emergencies are not only encountered in perinatal period as post-partum hemorrhage, ruptured uterus, retained placenta, etc. but also in early pregnancy as ruptured ectopic, complications of abortion, antepartum haemorrhage and ante-partum eclampsia all being equally fatal.…”

“…but also in early pregnancy as ruptured ectopic, complications of abortion, antepartum haemorrhage and ante-partum eclampsia all being equally fatal. [1][2][3][4] Though measures to reduce maternal mortality have decreased the rate but still the rates are high in developing countries according to WHO. 5 Plenty of studies on maternal mortality have been done but none on obstetric emergencies and its effect on maternal and perinatal mortality in Nepal.…”