Obstetrics injuries during shoulder dystocia in a tertiary perinatal center

Habek, Dubravko; Prka, Matija; Luetić, Ana Tikvica; Márton, Ingrid; Medić, Filip; Miletić, Antonio Ivan

doi:10.1016/j.ejogrb.2022.09.009

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…Obstetrics is a profession of high professional and forensic risk, and numerous forensic reports and expertise emphasize constant basic and constant "refresh" education as the basis for preventing unwanted events and thus preserving the dignity of the professionalism of obstetrics [1][2][3][4]. Thus, recent works indicate a significant reduction of birth injuries in SD with continuous training of skills [1][2][3][4][5][6][7][8][9], as well as in VBD [10][11][12][13][14], with the desire and will to improve skills, especially in the delivery of twins and VBD, although with a smaller share due to insufficient numbers according to a recent New Zealand study [14]. Also, there are articles by Swiss authors who critically processed the monitoring and interpretation of the learning curve of residents from performing CS, as well as basic abdominal operations in obstetrics [15], and Soergel et al [16] presented article in which they found that experience during CS reaches a plateau after 10-15 CS, however, they emphasize that the learning process is highly individualized and difficult to predict, so supervision and evaluation of the resident by an experienced surgeon is important.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction and Experiences of Gynecology and Obstetrics Residents in Croatia and Bosnia and Herzegovina with Training in Obstetrics

Habek,

Cerovac,

Mikuš

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: Specialization in gynecology and obstetrics is declared by the laws and regulations of individual countries prescribed by the competent Ministry of Health, as well as in Croatia and Bosnia and Herzegovina. Methods: During the daily clinical practice, educational unevenness and dissatisfaction of individual residents were noticed along with other organizational-communication and professional problems in basic obstetric skills, which we objectified by a voluntary anonymous survey of 122 residents of gynecology and obstetrics (RGO) from Croatia and Bosnia and Herzegovina. Residents completed survey during their postgraduate resident education. Results: RGOs state global dissatisfaction with specialization in 78.6%, believe in 84.4% that the skills and number of skills are not consistent with the years of specialization and 89.3% believe that they do not have enough skills to be able to work independently after specialization. Thus, the average number of skills from the first level competencies according to 1-5 years of specialization correlates with the above: the average number of cesarean section is 95.6, vaginal breech delivery extremely low 2.2, vacuum extration 6, forceps in the Croatia and Bosnia and Herzegovina does not perform, care of obstetrics anal sfincter injuries average 3 as well as shoulder distotia, internal version 0.36 and external version 0.6. Thus, 29.5% of them believe that there is a global lack of interest in the specialization system, 31.9% cite the incompetence of mentors, 33.6% the usual practice of individual schools and clinics. In conclusion, 59.8% of RGOs believe that obstetrics is a challenging profession, 10.6% a demanding profession, 18.8% consider it a dangerous occupation, only 13.9% an attractive occupation, and the fact that obstetrics has turned into a profession with caesarean sections as the most common skill is considered by 56.6%, even 84.2% of RGOs in the last year of specialization. Conclusions: There is evidently an academic-professional disproportion between the necessity and need for education and skills, that is, required competencies and reality. We must become and be arbiters between anti-obstetrics and obstetrics full of skills and craftsmanship as a true profession of allopathic conventional medicine, and academic honesty towards RGOs.

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Section: Discussionmentioning

confidence: 99%

Satisfaction and Experiences of Gynecology and Obstetrics Residents in Croatia and Bosnia and Herzegovina with Training in Obstetrics

Habek,

Cerovac,

Mikuš

et al. 2023

Clin. Exp. Obstet. Gynecol.

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“…Continuous training, education of midwives and obstetricians and quick reaction to the situation according to the protocol is the basis for reducing the consequent complications of shoulder dystocia, which we proved in our recent work on about 50,000 births without permanent OBP and one CP for a total of 0.7% shoulder dystocia in a tertiary perinatal centre. 5 We suggest the above as a solution to the problem of shoulder dystocia with the goal of good clinical practice and adhere to the majority of recent works that advise continuous skill training and starting the gradual release of trapped shoulders immediately after diagnosis as an obstetric standard. Timely information to the mother and family is necessary, no matter how impossible it seems in a clinical emergency.…”

Section: Covering Up the Diagnosis Of Intrapartum Foetalmentioning

confidence: 99%

Medico-legal problems and shoulder dystocia

Habek

2023

Med Leg J

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“…12 La distocia de hombros al ser un evento hiperagudo y una complicación obstétrica impredecible en partos vaginales con presentación cefálica y con importante impacto en la morbilidad y mortalidad del recién nacido. 13 Requiere acciones urgentes para prevenir la invalidez permanente por lesión obstétrica periparto o asfixia con importantes implicaciones médico-legales.…”

Section: Fractura De Clavículaunclassified