Abstract:
OBJECTIVE:To develop a simulation-based curricular unit for labor and delivery teams involved in obstetric emergencies to detect and address common mistakes. METHODS:A simulation-based curricular unit for hands-on training of four obstetric emergency scenarios was developed using high-tech mannequins and low-tech simulators. The scenarios were eclamptic seizure, postpartum hemorrhage, shoulder dystocia, and breech extraction. The obstetric teams consisted of at least one resident and two midwives. Checklists of actions expected from the teams were handed out to the course's tutors who observed the "event." All sessions were videotaped and then reviewed and analyzed by the trainees themselves, who were guided by two experienced tutors. We identified the most commonly occurring mistakes by summing up checklists and by watching the recorded sessions. RESULTS:Between February 2004 and April 2006, 60 residents in obstetrics and gynecology and 88 midwives underwent the simulation-based course. Forty-two labor and delivery teams completed all four sessions. The most common management errors were delay in transporting the bleeding patient to the operating room (82%), unfamiliarity with prostaglandin administration to reverse uterine atony (82%), poor cardiopulmonary resuscitation techniques (80%), inadequate documentation of shoulder dystocia (80%), delayed administration of blood products to reverse consumption coagulopathy (66%), and inappropriate avoidance of episiotomy in shoulder dystocia and breech extraction (32%). Eighteen trainees were invited for repeated sessions at least 6 months after the first training day, and their scores were significantly higher in the latter sessions (79.4+/-4.3 versus 70+/-5.3 for the second and first simulated eclampsia sessions). CONCLUSION:A curricular unit based on simulation of obstetric emergencies can identify pitfalls of management in labor and delivery rooms that need to be addressed.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Maslovitz S,Barkai G,Lessing JB,Ziv A,Many Adoi
10.1097/01.AOG.0000265208.16659.c9subject
Has Abstractpub_date
2007-06-01 00:00:00pages
1295-300issue
6eissn
0029-7844issn
1873-233Xpii
109/6/1295journal_volume
109pub_type
杂志文章abstract::Periodic assessments offer an excellent opportunity for obstetricians and gynecologists to provide preventive screening, evaluation, and counseling. The American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice recommends routine assessments in primary and preventive care for women based o...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e318219226e
更新日期:2011-04-01 00:00:00
abstract::The danger to the newborn inherent in a postmature pregnancy has gained recognition. However, the diagnosis of postmaturity remains a difficult problem. The thromboplastic activity of amniotic fluid (TAAF) increases with the gestational age. Based on this phenomenon, the TAAF of 45 women in the 41st to 43rd weeks of g...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of intrauterine growth restriction (IUGR) infants with abnormal pulsatility index of the umbilical artery according to the neonatal birth weight/gestational age standards and the intrauterine growth charts. METHODS:We analyzed 53 pregnancies with severe IUGR classified as group 2 (22 ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31818bdc7e
更新日期:2008-12-01 00:00:00
abstract::Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites tha...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000410162.34363.0b
更新日期:2012-01-01 00:00:00
abstract::As the human immunodeficiency virus (HIV) epidemic affects more women, clinicians are increasingly observing pelvic inflammatory disease (PID) in HIV-infected women. The extent to which PID is a factor in the recognition of HIV or HIV is a factor in the recognition of PID is unknown. Even less is known about how HIV i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Cefmenoxime, a new third-generation cephalosporin, was used as a single drug in the therapy for female genital tract infections. Therapeutic response was considered satisfactory in 21 of 22 cases of pelvic inflammatory disease, six of nine tuboovarian abscesses, two of three severe wound infections, and all five cases...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:Zika virus infection during pregnancy is a cause of microcephaly and other fetal brain abnormalities. Reports indicate that the duration of detectable viral RNA in serum after symptom onset is brief. In a recent case report involving a severely affected fetus, Zika virus RNA was detected in maternal serum 10 ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001625
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To assess the effect of antenatal and postnatal corticosteroids on head circumference growth and weight gain from birth to discharge. METHODS:We conducted a retrospective analysis of nonanomalous newborns admitted to the neonatal intensive care unit from 23 to 34 6/7 weeks of gestation. Independent variables...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01657-x
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To prospectively validate the Sepsis in Obstetrics Score, a pregnancy-specific sepsis scoring system, to identify risk for intensive care unit (ICU) admission for sepsis in pregnancy. METHODS:This is a prospective validation study of the Sepsis in Obstetrics Score. The primary outcome was admission to the IC...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002260
更新日期:2017-10-01 00:00:00
abstract::A preliminary report is made of 11 patients of childbearing age treated for symptomatic uterine prolapse by a suspension technic employing straps of external oblique aponeurosis according to the method of Williams and Richardson. In a relatively short period of follow-up, the operative results have been excellent in a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1967-08-01 00:00:00
abstract::The histories of 386 patients with untreated hydatidiform mole were reviewed to define the clinical aspects of accompanying theca lutein cysts. These cysts occurred in 102 patients (26.4%), with three patients experiencing cyst-related complications. Mean cyst size at diagnosis was 7.3 cm (3-20 cm), and did not correl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract::The pregnancy of a woman with Friedreich ataxia was complicated by the onset of preterm labor and preeclampsia. Administration of magnesium sulfate (MgSO4.7H2O) in the usual intravenous dosage resulted in the dramatic development of profound motor weakness and respiratory distress. Magnesium acts to antagonize the act...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To challenge the hypothesis that discordant growth is a normal variation by relating birth weight discordance to total twin birth weight. METHODS Among 12,565 Israeli live-born twin pairs (1993-98), we compared total twin birth weight decile, the frequencies of three levels of discordance in the general popul...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01079-6
更新日期:2000-12-01 00:00:00
abstract::Blood coagulation and fibrinolytic inhibitors and the balance between and within the two systems were investigated in 26 normal pregnant women during pregnancy and the puerperium. The concentration of the coagulation inhibitors antithrombin and protein C remained within normal levels, whereas the mean level of free pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:To determine whether the overall retention of weight gained during pregnancy and the factors affecting postpartum weight retention differ by race. METHODS:Data from the 1988 National Maternal and Infant Health Survey were analyzed to examine postpartum weight retention of 20 lb or more among 990 black and 11...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:Over-the-counter vaginal lubricants have been shown to negatively affect in vitro sperm motility. The objective of this study was to estimate the effect of vaginal lubricant use during procreative intercourse on natural fertility. METHODS:Women aged 30-44 years with no history of infertility who had been try...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31825b87ae
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To determine in pregnant women with preterm labor the relative efficacy of the amniotic fluid index (AFI) and the two-diameter pocket to detect abnormalities in amniotic fluid volume (AFV), and to relate these findings to pregnancy outcome. METHODS:Fifty-seven healthy women with preterm labor underwent amnio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199406000-00012
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:To describe ethnic differences in tobacco use during pregnancy in a clinical population of Mexican-American and non-Hispanic white women. METHODS:Subjects were randomly selected from all patients attending a university-based obstetrics clinic in Tucson, Arizona. Of 555 subjects selected, 367 were interviewed...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:Posttraumatic stress disorder (PTSD) is a serious anxiety disorder triggered by the experience of trauma. One in 4 individuals exposed to trauma will develop PTSD. Victims of trauma are frequent users of health care, but screening is rarely done and most sequelae remain undetected. Our objectives were 1) to d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000140683.43272.85
更新日期:2004-10-01 00:00:00
abstract::Fifteen fallopian tubes in which a previous ipsilateral eccyesis was managed by conservative surgical techniques were examined. The condition of the tube relative to the previous surgical management and the resolution of the previous implantation sites were correlated with the recurrent tubal pregnancy. All previous i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock is a rapidly progressive disease associated with injury to multiple organ systems and a 30-60% mortality rate. We present a case of a 40-year-old woman who developed group A strep...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::Five hundred twelve patients who presented with initial atypical cervical cytology between February 1982 and February 1983 at Naval Hospital, San Diego were randomized with respect to antibiotic treatment and interval before repeat cytologic examination. Treatment before repeat cytology did not improve the rate of rev...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:To estimate the changes in central hemodynamics features of pregnant women presenting with hypertensive disorders and to analyze the effects of standard antihypertensive treatment on maternal central hemodynamics. METHODS:Applanation tonometry was used to record the radial artery pulse waveform in 80 women p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318197c392
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To determine the relation between cervical conization and preterm birth. METHODS:All Danish women with singleton pregnancies who gave birth to their first infant in 1982 and second infant during the time period 1982-1987 were included in a register-based cohort study. Information on pregnancy outcome and cer...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ov...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0b013e3181b5a547
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Laceration of the iliac veins and their branches is a feared complication in abdominal sacral colpopexy. Hemorrhages can be extensive and difficult to control. CASE:We report a case of a patient who, while undergoing abdominal sacral colpopexy, was found to have confluence of the iliac veins at the level of...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182062053
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To study the association between hysterectomy for benign indications and pelvic organ fistula disease. METHODS:We conducted a nationwide cohort study based on Swedish health care registers. The cohort consisted of 182,641 women having hysterectomy (exposed cohort) and 525,826 women not undergoing the procedu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181b2a1df
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of endocervical dysplasia in women with cervical cytology of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (SIL) who have a satisfactory and normal colposcopic examination. METHODS:An electronic colposcopy database was revi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00821-8
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To determine whether preoperative ketoprofen and mesosalpinx infiltration, either alone or in combination, favorably influence postoperative recovery after outpatient laparoscopic sterilization. METHODS:In a double-blind, randomized, placebo-controlled study, 20 women received 100 mg of oral ketoprofen preop...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(96)00222-0
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:To assess the ability of obstetricians to recognize parturients at risk for difficult intubation and to examine the effect of education in airway examination on that ability. METHODS:The airways of 160 parturients were examined by four physicians: one attending and one resident obstetrician, and one attendi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00552-3
更新日期:1999-05-01 00:00:00