[Simulation' benefits in obstetrical emergency: Which proof level?]

Area of Science:

• Medical Simulation
• Obstetrics and Gynecology
• Emergency Medicine Training

Background:

• Simulation is increasingly used for obstetrical emergency training.
• The economic and human costs necessitate evaluating its effectiveness.
• Key areas for evaluation include technical/non-technical skills and patient outcomes.

Purpose of the Study:

• To review the literature on the impact of simulation training in obstetrical emergencies.
• To assess evidence for improvements in skills, maternal, and neonatal morbidity/mortality.
• Focus on high-evidence publications concerning shoulder dystocia, postpartum hemorrhage, eclampsia, and cord prolapse.

Main Methods:

• Literature review of published results on obstetrical emergency simulation.
• Selection of publications with high evidence levels or demonstrated positive training impact.
• Analysis of studies focusing on specific emergencies: shoulder dystocia, postpartum hemorrhage, eclampsia, cord prolapse.

Main Results:

• Few publications demonstrate a clear positive impact of training on obstetrical emergencies.
• Shoulder dystocia training showed significant reductions in brachial plexus injury (75% after 4 years, 100% permanent injury after 10 years).
• Limited evidence for reduction in severe postpartum hemorrhage; crew resource management and team training generally improved.

Conclusions:

• Simulation training in obstetrics holds promise but requires more robust evidence.
• Demonstrated success in reducing shoulder dystocia-related injuries suggests potential.
• Further research is crucial to validate benefits for maternal/neonatal outcomes and severe postpartum hemorrhage.